中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2012年
10期
793-797
,共5页
刘秋玲%王亚峰%毛更生%杨新吉%孙岩峰%苗丽霞%王军%袁海莲%李彦珊%刘红艳%王晓玲%赵飞
劉鞦玲%王亞峰%毛更生%楊新吉%孫巖峰%苗麗霞%王軍%袁海蓮%李彥珊%劉紅豔%王曉玲%趙飛
류추령%왕아봉%모경생%양신길%손암봉%묘려하%왕군%원해련%리언산%류홍염%왕효령%조비
放射学,介入性%眼动脉%抗肿瘤联合化疗方案%视网膜母细胞瘤%儿童
放射學,介入性%眼動脈%抗腫瘤聯閤化療方案%視網膜母細胞瘤%兒童
방사학,개입성%안동맥%항종류연합화료방안%시망막모세포류%인동
Radiology,interventional%Ophthalmic artery%Antineoplastic combined chemotherapy protocols%Retinoblastoma%Child
目的 评价经眼动脉介入化疗(IAC)治疗眼内期视网膜母细胞瘤(RB)的临床安全性.方法 选择2009年1月至2011年9月诊断为眼内期RB的患儿42例52只患眼行IAC治疗,评价IAC治疗的安全性.42例中8例11只眼行1个疗程,31例38只眼行2个疗程,3例3只眼行3个疗程IAC,累计治疗96例次,两个疗程IAC间隔1个月.观察IAC术中、术后患儿外眼及全身临床表现变化及治疗前后血常规、丙氨酸氨基转移酶(ALT)、血肌酐(Scr)、肌酸激酶MB同工酶(CK-MB)变化.结果 (1)42例患儿52只患眼中44只眼肿瘤不同程度缩小,有效率84.6％.(2)全部患儿介入手术过程顺利,未出现术中严重并发症.(3)IAC术后最多见局部并发症为眼睑肿胀及眼睑下垂,发生率1个疗程组分别为18％(2/11)与9％(1/11)；2个疗程组分别为29％(11/38)与21％ (8/38)；3个疗程组均为100％(3/3).少见并发症为玻璃体出血及斜视,发生率均为2％(1/42).眼睑肿胀和眼睑下垂的发生率2个疗程组与1个疗程组差异无统计学意义(P均＞0.05)；3个疗程组较2个疗程组及1个疗程组均明显增加(P均＜0.01).(4)全部患儿均未出现发热、败血症等全身并发症.(5)19％(8/42)患儿出现一过性ALT升高,24％(10/42)患儿出现CK-MB升高,分别将1个疗程组、2个疗程组、3个疗程组治疗前与治疗后24 h血细胞数、ALT、Scr、CK-MB进行比较,差异均无统计学意义(P均＞0.05).结论 本组资料提示IAC治疗眼内期RB安全有效,患儿毒副反应小.
目的 評價經眼動脈介入化療(IAC)治療眼內期視網膜母細胞瘤(RB)的臨床安全性.方法 選擇2009年1月至2011年9月診斷為眼內期RB的患兒42例52隻患眼行IAC治療,評價IAC治療的安全性.42例中8例11隻眼行1箇療程,31例38隻眼行2箇療程,3例3隻眼行3箇療程IAC,纍計治療96例次,兩箇療程IAC間隔1箇月.觀察IAC術中、術後患兒外眼及全身臨床錶現變化及治療前後血常規、丙氨痠氨基轉移酶(ALT)、血肌酐(Scr)、肌痠激酶MB同工酶(CK-MB)變化.結果 (1)42例患兒52隻患眼中44隻眼腫瘤不同程度縮小,有效率84.6％.(2)全部患兒介入手術過程順利,未齣現術中嚴重併髮癥.(3)IAC術後最多見跼部併髮癥為眼瞼腫脹及眼瞼下垂,髮生率1箇療程組分彆為18％(2/11)與9％(1/11)；2箇療程組分彆為29％(11/38)與21％ (8/38)；3箇療程組均為100％(3/3).少見併髮癥為玻璃體齣血及斜視,髮生率均為2％(1/42).眼瞼腫脹和眼瞼下垂的髮生率2箇療程組與1箇療程組差異無統計學意義(P均＞0.05)；3箇療程組較2箇療程組及1箇療程組均明顯增加(P均＜0.01).(4)全部患兒均未齣現髮熱、敗血癥等全身併髮癥.(5)19％(8/42)患兒齣現一過性ALT升高,24％(10/42)患兒齣現CK-MB升高,分彆將1箇療程組、2箇療程組、3箇療程組治療前與治療後24 h血細胞數、ALT、Scr、CK-MB進行比較,差異均無統計學意義(P均＞0.05).結論 本組資料提示IAC治療眼內期RB安全有效,患兒毒副反應小.
목적 평개경안동맥개입화료(IAC)치료안내기시망막모세포류(RB)적림상안전성.방법 선택2009년1월지2011년9월진단위안내기RB적환인42례52지환안행IAC치료,평개IAC치료적안전성.42례중8례11지안행1개료정,31례38지안행2개료정,3례3지안행3개료정IAC,루계치료96례차,량개료정IAC간격1개월.관찰IAC술중、술후환인외안급전신림상표현변화급치료전후혈상규、병안산안기전이매(ALT)、혈기항(Scr)、기산격매MB동공매(CK-MB)변화.결과 (1)42례환인52지환안중44지안종류불동정도축소,유효솔84.6％.(2)전부환인개입수술과정순리,미출현술중엄중병발증.(3)IAC술후최다견국부병발증위안검종창급안검하수,발생솔1개료정조분별위18％(2/11)여9％(1/11)；2개료정조분별위29％(11/38)여21％ (8/38)；3개료정조균위100％(3/3).소견병발증위파리체출혈급사시,발생솔균위2％(1/42).안검종창화안검하수적발생솔2개료정조여1개료정조차이무통계학의의(P균＞0.05)；3개료정조교2개료정조급1개료정조균명현증가(P균＜0.01).(4)전부환인균미출현발열、패혈증등전신병발증.(5)19％(8/42)환인출현일과성ALT승고,24％(10/42)환인출현CK-MB승고,분별장1개료정조、2개료정조、3개료정조치료전여치료후24 h혈세포수、ALT、Scr、CK-MB진행비교,차이균무통계학의의(P균＞0.05).결론 본조자료제시IAC치료안내기RB안전유효,환인독부반응소.
Objective To investigate the safety of treatment with ophthalmic artery cannulation for intra-arterial chemotherapy(IAC) for children with intraocular retinoblastoma (RB).Method In the RB Treatment Center of General Hospital of Armed Police Forces between January 2009 and September 2011,42 patients who were diagnosed intraocular RB and treated with ophthalmic artery cannulation for IAC,8 patients were treated 1 circle,31 patients were treated 2 circles and 3 patients were treated 3 circles (total,96 times).Each month had IAC once.The ophthalmic and the whole body evaluations were performed during IAC and after IAC for each circle,the blood cell count,alanine aminotransferase (ALT),serum creatinine (Scr),CK-MB content before and after IAC for 1 circle,2 circles and 3 circles were determined.Result (1) In 52 eyes of 42 patients,44 eyes (84.6％) were in remission.(2) Successful IAC was achieved in all cases,no severe side effects occurred during IAC.(3) The main ophthalmic complications were eyelid edema and blepharoptosis after IAC,the incidence for 1 circle was 18％ (2/11)and 9％ (1/11) ; for 2 circles was 29％ (11/38) and 21％ (8/38) ; for 3 circles was all 100％ (3/3).The rare complications were vitreous hemorrhage and heterotropia,the incidence was all 2％ (1/42).The incidence of eyelid edema and blepharoptosis had no significant differences for 1 circle IAC compared with 2 circles(P ＞ 0.05) ;the incidence of eyelid edema and blepharoptosis had significant differences for 3 circles IAC compared with 2 circles and 1 circle (P ＜ 0.01).(4) No fever,septicemia and other systemic toxic effects occurred.(5) ALT of 19％ patients (8/42) elevated temporarily and CK-MB of 24％ patients (10/42) increased.The blood cell counts,ALT,Scr,and CK-MB content before IAC had no significant differences compared with that at 24 h after IAC for 1 circle,2 circles and 3 circles (P ＞ 0.05).Conclusion Ophthalmic artery cannulation for IAC is a safe and effective method in treating intraocular stage retinoblastoma.
