CAJ | 학술논문

目的评价多点皮内注射肝素钠治疗早期眼睑黄色瘤的疗效.方法前瞻性病例对照研究.30例双眼早期黄色瘤患者,其中男6例,女24例,年龄36～58岁,平均(42±11)岁.使用游标卡尺测量计算瘤体面积为15.21～23.67 mm2,平均(18.16±1.82)mm2,两眼病变部位皮肤均无明显增厚.随机选择一眼行多点皮内注射(多点皮内注射眼组),另一眼行单点皮内注射(单点皮内注射眼组).两组间治疗前瘤体面积差异无统计学意义.注射方法:多点皮内注射眼均沿病变短径均匀分成3点行肝素钠瘤体皮内注射,每点625 U(0.1ml),共0.3 ml;单点皮内注射眼沿病变长径进针注射0.3 ml.两组均为每周注射1次,治愈后停止注射.疗程及病变面积变化采用配对t检验,病情转归采用Ridit统计分析,复发率分析采用Kaplan-Meier生存分析.结果所有患者双眼均治愈,多点皮内注射眼组平均注射(2.9±0.9)次,单点皮内注射眼组平均注射(3.8±0.8)次,差异有统计学意义(t=-3.970,P＜0.05).第1～4次注射后多点皮内注射眼组疗效优于单点皮内注射眼组,经Ridit分析差异有统计学意义(Z=4.994、4.577、4.323、2.683,P均＜0.01).第1～4次注射后1周两组病变面积差异均有统计学意义(t=3.790、6.414、3.302、2.347、P＜0.05).除2例出现注射局部暂时性轻度色素沉着外,无一例发牛皮肤坏死、皮下疤痕及皮肤弹性的改变.随访24-58个月不等,经Kaplan-Meier生存分析两组复发情况差异无统计学意义.结论多点皮内注射肝素钠治疗眼睑早期黄色瘤疗程短、恢复快.
목적 평개다점피내주사간소납치료조기안검황색류적료효.방법 전첨성병례대조연구.30례쌍안조기황색류환자,기중남6례,녀24례,년령36～58세,평균(42±11)세.사용유표잡척측량계산류체면적위15.21～23.67 mm2,평균(18.16±1.82)mm2,량안병변부위피부균무명현증후.수궤선택일안행다점피내주사(다점피내주사안조),령일안행단점피내주사(단점피내주사안조).량조간치료전류체면적차이무통계학의의.주사방법:다점피내주사안균연병변단경균균분성3점행간소납류체피내주사,매점625 U(0.1ml),공0.3 ml;단점피내주사안연병변장경진침주사0.3 ml.량조균위매주주사1차,치유후정지주사.료정급병변면적변화채용배대t검험,병정전귀채용Ridit통계분석,복발솔분석채용Kaplan-Meier생존분석.결과 소유환자쌍안균치유,다점피내주사안조평균주사(2.9±0.9)차,단점피내주사안조평균주사(3.8±0.8)차,차이유통계학의의(t=-3.970,P＜0.05).제1～4차주사후다점피내주사안조료효우우단점피내주사안조,경Ridit분석차이유통계학의의(Z=4.994、4.577、4.323、2.683,P균＜0.01).제1～4차주사후1주량조병변면적차이균유통계학의의(t=3.790、6.414、3.302、2.347、P＜0.05).제2례출현주사국부잠시성경도색소침착외,무일례발우피부배사、피하파흔급피부탄성적개변.수방24-58개월불등,경Kaplan-Meier생존분석량조복발정황차이무통계학의의.결론 다점피내주사간소납치료안검조기황색류료정단、회복쾌.
Objective To evaluate the therapeutic effect of heparin sodium (HS) intradermal injections at multiple points for early xanthoma palpebrarum.Methods It was a prospective case-control study.There were 6 men and 24 women ranging in age from 36 to 58 years old,with an average age of 42±11 years.The lesion ranged from 15.21-23.67 mm2,with an average of 18.16±1.82 mm2.One eye of each patient given intradermal injections of heparin sodium (HS) with multiple points (multiple points injections eyes group) and the other eye was given single point (single point injection eyes group) in random.The difference in lesion areas before treatment between the two groups was without statistical significance.The method of injections was as follow:intradermal injections of HS were given by selecting 3 uniformpoints along the short diameters of the lesion areas with a dosage of 625 U (0.1 ml) per point (a total of 1875 U/0.3 ml) in multiple points injections eyes group.The same dosage (0.3 ml) was given along the long diameters in single point injection eyes group.The therapies were administered once a week for all patients.The changes in the lesion areas were recorded one week after the therapies.The therapies stopped when the diseases were cured.The therapeutic course and the changes of lesion areas were compared by paired t test,the turnovers of diseases were assesses by Ridit statistical analysis and the recurrence rates of diseases were assessed by Kaplan-Meier survival analysis.Results ①All patients were cured.However,therapy for multiple points injections eyes group (2.9t±0.9 times) were shorter than single point injection eyes group (3.8±0.8 times) with significant difference (t=-3.970,P＜0.05).②A week after the first to fourth therapies,the effect on multiple points injections group was better than single point injection eyes group and Ridit statistical analysis showed a significant difference (Z=4.994,4.577,4.323,2.683,respectively; P＜0.01 for all).③A week after the first to fourth therapies,the reduction in the lesion areas in multiple points injections group was greater than single point injection eyes group (t=3.790,6.414,3.302,2.347,respectively; P＜0.05 for all).④Cutaneous necrosis,cicatricial tissue or the changes in elasticity of the skins did not occur in any patients except for 2 cases with a slight temporary skin pigmentation.⑤After 24-58 months followed up,there was no statistical significance for the recurrence rates in the two groups with a Kaplan-Meier survival analysis.Conclusion The course of treatment for early xanthoma palpebrarum could be shortened by intradermal injections of heparin sodium with multiple points.