CAJ | 학술논문

目的了解以眼眶包块起病的儿童眼眶恶性嗜酸性肉芽肿的临床特点及疗效分析.方法 2007年4月至2013年4月收治的经病理诊断为嗜酸性肉芽肿患儿15例.男11例,女4例;中位年龄2.25岁(1～12岁).15例患儿应用MVP[甲氨蝶呤(M)+长春新碱(V)+泼尼松(P)]化疗方案治疗4例,改良化疗方案DAL-HX 83/90方案(依托泊苷+泼尼松+长春新碱)治疗11例.13例经手术结合化疗治疗,2例行单纯化疗治疗.统计分析15例患儿的临床发病特点、疗效及预后.结果 1.首发症状:眼眶包块、眼眶突出13例(86.7％),病眼斜视、视力下降、眼痛3例(13.3％);15例患儿均无发热表现.2.发病眼别:右眼眶起病7例(46.7％),左眼眶8例(53.3％).3.随访至2013年10月,中位随访时间17个月(8～71个月),15例均获随访.13例患儿病灶完全吸收,2例病灶大部分吸收,所有患儿未见局部复发.5例患儿斜视、视力下降及眼痛经治疗后症状好转,无功能障碍.结论儿童眼眶恶性嗜酸性肉芽肿起病隐匿,临床表现不典型,应注意鉴别诊断.儿童眼眶嗜酸性肉芽肿对化疗敏感,经综合治疗及随访病灶吸收率较高.
목적 료해이안광포괴기병적인동안광악성기산성육아종적림상특점급료효분석.방법 2007년4월지2013년4월수치적경병리진단위기산성육아종환인15례.남11례,녀4례;중위년령2.25세(1～12세).15례환인응용MVP[갑안접령(M)+장춘신감(V)+발니송(P)]화료방안치료4례,개량화료방안DAL-HX 83/90방안(의탁박감+발니송+장춘신감)치료11례.13례경수술결합화료치료,2례행단순화료치료.통계분석15례환인적림상발병특점、료효급예후.결과 1.수발증상:안광포괴、안광돌출13례(86.7％),병안사시、시력하강、안통3례(13.3％);15례환인균무발열표현.2.발병안별:우안광기병7례(46.7％),좌안광8례(53.3％).3.수방지2013년10월,중위수방시간17개월(8～71개월),15례균획수방.13례환인병조완전흡수,2례병조대부분흡수,소유환인미견국부복발.5례환인사시、시력하강급안통경치료후증상호전,무공능장애.결론 인동안광악성기산성육아종기병은닉,림상표현불전형,응주의감별진단.인동안광기산성육아종대화료민감,경종합치료급수방병조흡수솔교고.
Objective To study clinical character and analysis efficacy of orbit malignant eosinophilic granuloma for first symptom with orbit mass in children.Methods A total of 15 patients with orbit malignant eosinophilic granuloma in children were diagnosed using pathology hospital from Apr.2007 to Apr.2013 (11 cases of male,4 cases of female).The median age was 2.25 years old(1-12 years).In 15 cases,4 cases of chemotherapy using MVP project [methylamine (M) + viucristine(V) + prednisone(P)],and 1 1 cases of chemotherapy using DAL-HX 83/90 project [etoposide (VP-16) + prednisone + vinblastine].Thirteen cases were treated by using surgery and chemotherapy,and 2 cases were treated using single chemotherapy.Statistics analysis clinical characters,efficacy and prognosis of 15 cases of malignant orbit eosinophilic granuloma in children.Results 1.First symptom:13 cases of orbit mass and extruded with eyeball(86.7％),3 cases of strabismus and diminution of vision and eyes pain(13.3％),and no fever of all patients.2.Eye of the disease come on:right orbit was 7 cases,accounted for 46.7％,and left orbit was 8 cases,accounted for 53.3 ％.3.Follow up to Oct.2013,median time was 17 months (8-71 months),15 cases were followed.The niduses of 13 cases were complete absorbed,the niduses of 2 cases were most absorbed.In 15 cases,no patient was relapse.Five patients with strabismus and diminution of vision and eyes pain were recover after chemotherapy and no function obstruction.Conclusions Malignant orbital eosinophilic granuloma in children insidious onset,and atypical clinical manifestations,should pay attention to the differential diagnosis.Orbital eosinophilic granuloma in children sensitive to chemotherapy.The focus absorption rate by comprehensive treatment and follow-up is higher.