沙培林瘤内注射治疗体表血管瘤\脉管畸形的国内文献系统评价(1)
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[摘要]目的:对沙培林瘤内注射治疗体表血管瘤、脉管畸形的疗效和安全性进行客观系统的评价。方法:计算机及人工检索中文文献,将纳入文献报道的患者性别、年龄范围、畸形类型、部位、大小和治疗效果等进行合并,计算各种类型血管瘤、脉管畸形的疗效。结果:纳入的22篇文献20篇为临床回顾性研究,非随机、非对照。沙培林对不同类型血管瘤、脉管畸形的治愈率依次为:海绵状血管瘤57.07%,毛细血管瘤71.43%(鲜红斑痣血管瘤80%),囊状淋巴管瘤76.83%,混合及海绵状淋巴管瘤53.6%。结论:目前资料显示,沙培林瘤内注射治疗血管瘤、脉管畸形有一定疗效;与平阳霉素相比,沙培林治疗淋巴管畸形的疗效更好一些。应根据血管瘤、脉管畸形的最新分类,重新进行前瞻性随机对照研究。
[关键词]沙培林;血管瘤;脉管畸形;体表;系统评价
[中图分类号]R782 [文献标识码]A [文章编号]1008-6455(2010)10-1472-04
Intralesional injection of Sapylin for hemangiomas and vascular malformations:A systematic review of the Chinese literature
WEI Hhai-gang,QIU Ya,CHEN Yu-ting,LI Shu-guang
(Departement of Oral and Maxillofacial surgery, Foshan Second People's Hospital,Foshan 528000,Guangdong,China)
Abstract:Objective To assesses the efficacy and safety of intralesional injection of sapylin for Hemangiomas and Vascular Malformations in body surface.MethodsAsystematic review of all relevant clinical trials in Chinese literature was performed using electric and hand searching. The reported sex, age ranges,the type,site,size of the tumors and the treatment results were identified and analyzed with conflation algorithm.Results22 articles included 20 studieswere clinical retrospective trials without random and control. The curative rates of sapylin were57.07% for cavemous hemangioma,71.43% for capillary hemangioma(80.0% for strawberry type),76.83% for cystic lymphangioma,53.6% for mixed and Cavernous lymphangioma, respectively.ConclusionSapylin is effective for hemangiomas and vascular malformations from the present data,and compared with pingyangmycin,sapylin treatment of lymphatic malformation is better.Further randomized prospective controlled trials are needed using the new classification of Waner and Suen (1995) to draw reliable conclusions.
Key words:Sapylin;hemangiomas;vascular malformations;body surface;systematic review
近年来抗生素类抗肿瘤药物瘤内注射治疗血管瘤、脉管畸形的应用较多,而且疗效也很肯定,常用的药有平阳霉素及沙培林。沙培林是低压冷冻干燥的生物制剂, 由经青霉素G处理过的溶血性链球菌组成,是一种非特异性的免疫增强剂,无毒副作用。其机制是通过刺激脉管内皮细胞产生无菌炎症反应,纤维组织增生,使淋巴管、血管闭塞而达到缩小甚至使囊性瘤体完全消失的效果。沙培林治疗脉管畸形最早由高解春等[1]于1993年报道,自此以后,采用沙培林瘤内注射治疗体表血管瘤和脉管畸形的临床报道不断增多,多数报道对其疗效予以肯定,并认为是目前简便、有效、安全的治疗方法 ......
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