中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2011年
6期
411-414
,共4页
马刚%林晓曦%江成鸿%陈辉%李伟%胡晓洁%金云波%陈达%陈晓东%叶肖肖
馬剛%林曉晞%江成鴻%陳輝%李偉%鬍曉潔%金雲波%陳達%陳曉東%葉肖肖
마강%림효희%강성홍%진휘%리위%호효길%금운파%진체%진효동%협초초
婴幼儿血管瘤%咪喹莫特%免疫调节剂
嬰幼兒血管瘤%咪喹莫特%免疫調節劑
영유인혈관류%미규막특%면역조절제
Infantile hemangioma%Imiquimod%Immunomodulator
目的 探讨咪喹莫特治疗婴幼儿血管瘤( infantile hemangioma,IH)的临床适应证.方法 320例婴幼儿血管瘤,浅表型250例,深在型20例,混合型50例,年龄3～24周,隔日夜间睡前外用5％咪喹莫特乳青涂擦16周,随访至1岁.疗效评价分为6级,1级:完全消退；2级:75％≤消退≤99％；3级:50％≤消退＜75％；4级:25％≤消退＜50％；5级:消退＜25％；6级:未消退或增生.记录局部皮肤反应及全身不良反应.结果 浅表型、深在型、混合型IH的有效率分别为61.2％(153/250)、10.0％ (2/20)、60.0％( 30/50).浅表型和混合型之间比较差异无统计学意义(P=0.874),浅表型与深在型之间比较差异有统计学意义(P＜0.01),深在型与混合型之间比较差异有统计学意义(P＜0.01).咪喹莫特外用后4～8周,IH开始生长控制并出现消退现象.56.0％ (28/50)混合型IH出现深部病灶的增生.皮肤反应主要为红斑、表皮剥落、结痂,程度轻微.结论 浅表型IH和混合型IH的浅表病灶是外用咪喹莫特治疗的适应证,治疗后局部皮肤反应轻微,不引起局部组织萎缩和身体发育迟滞,对腔穴部位及皮肤皱褶处应避免使用,用药方式简单便捷,可作为IH浅表病灶的安全有效的治疗方法.
目的 探討咪喹莫特治療嬰幼兒血管瘤( infantile hemangioma,IH)的臨床適應證.方法 320例嬰幼兒血管瘤,淺錶型250例,深在型20例,混閤型50例,年齡3～24週,隔日夜間睡前外用5％咪喹莫特乳青塗抆16週,隨訪至1歲.療效評價分為6級,1級:完全消退；2級:75％≤消退≤99％；3級:50％≤消退＜75％；4級:25％≤消退＜50％；5級:消退＜25％；6級:未消退或增生.記錄跼部皮膚反應及全身不良反應.結果 淺錶型、深在型、混閤型IH的有效率分彆為61.2％(153/250)、10.0％ (2/20)、60.0％( 30/50).淺錶型和混閤型之間比較差異無統計學意義(P=0.874),淺錶型與深在型之間比較差異有統計學意義(P＜0.01),深在型與混閤型之間比較差異有統計學意義(P＜0.01).咪喹莫特外用後4～8週,IH開始生長控製併齣現消退現象.56.0％ (28/50)混閤型IH齣現深部病竈的增生.皮膚反應主要為紅斑、錶皮剝落、結痂,程度輕微.結論 淺錶型IH和混閤型IH的淺錶病竈是外用咪喹莫特治療的適應證,治療後跼部皮膚反應輕微,不引起跼部組織萎縮和身體髮育遲滯,對腔穴部位及皮膚皺褶處應避免使用,用藥方式簡單便捷,可作為IH淺錶病竈的安全有效的治療方法.
목적 탐토미규막특치료영유인혈관류( infantile hemangioma,IH)적림상괄응증.방법 320례영유인혈관류,천표형250례,심재형20례,혼합형50례,년령3～24주,격일야간수전외용5％미규막특유청도찰16주,수방지1세.료효평개분위6급,1급:완전소퇴；2급:75％≤소퇴≤99％；3급:50％≤소퇴＜75％；4급:25％≤소퇴＜50％；5급:소퇴＜25％；6급:미소퇴혹증생.기록국부피부반응급전신불량반응.결과 천표형、심재형、혼합형IH적유효솔분별위61.2％(153/250)、10.0％ (2/20)、60.0％( 30/50).천표형화혼합형지간비교차이무통계학의의(P=0.874),천표형여심재형지간비교차이유통계학의의(P＜0.01),심재형여혼합형지간비교차이유통계학의의(P＜0.01).미규막특외용후4～8주,IH개시생장공제병출현소퇴현상.56.0％ (28/50)혼합형IH출현심부병조적증생.피부반응주요위홍반、표피박락、결가,정도경미.결론 천표형IH화혼합형IH적천표병조시외용미규막특치료적괄응증,치료후국부피부반응경미,불인기국부조직위축화신체발육지체,대강혈부위급피부추습처응피면사용,용약방식간단편첩,가작위IH천표병조적안전유효적치료방법.
Objective To explore the clinical application of imiquimod for the treatment of infantile hemangiomas( IH ).Methods 320 children with IH,including 250 superficial cases,20 deep cases,and 50 mixed cases,were treated with 5％ imiquimod cream every other day for 16 weeks.The clinical efficacy and side effects were evaluated at one year of age.Results The total effective rates of the superficial,deep,and mixed IH were 61.2％ (153/250),10.0％ (2/20) and 60.0％ (30/50)respectively,showing no statistical difference between superficial and deep type ( P =0.874 ),but significant difference between superficial and mixed (P ＜ 0.01 ),deep and mixed type (P ＜ 0.01 ).56.0％(28/50) of mixed IH showed proliferation of its deep lesions.Slight skin erythema and crusting were the most common side effects.Conclusions 5％ imiquimod cream is effective and safe in superficial IH and superficial lesions of mixed IH with minimal skin reactions.The dysplasia of local tissue and systemic growth retardation are not found.It should be avoided to apply the cream to IH located around the cavities and skin fold.Imiquimod cream is a simple and convenient home-nursing medication.It can reduce care burden of family.Thus topical use of imiquimod can be considered as a good clinical indication for the treatment of superficial lesions of IH.
