核素32P治疗538例皮肤血管瘤的临床分析

 [摘要] 目的 研究核素³²P敷贴治疗草莓状、鲜红斑痣两种皮肤血管瘤的效果。探讨患者年龄、性别、发病部位以及血管瘤类型等因素对³²P敷贴治疗疗效的影响。方法 皮肤血管瘤患者共538例，将³²P药膜贴于皮肤血管瘤处,根据患儿年龄大小及血管瘤生长部位确定病变敷贴时间。结果 年龄对³²P敷贴治疗效果有明显影响(P<0.001), ≤6个月组皮肤毛细血管瘤治疗有效率明显高于＞6月组 (P<0.001)。不同性别³²P治疗有效率差别无统计学意义（P>0.05）。单部位血管瘤与多发部位血管瘤病例治疗有效率差别无统计学意义（P>0.05）。血管瘤类型不同, ³²P敷贴治疗效果有明显差别，草莓状血管瘤治疗有效率明显高于鲜红斑痣治疗有效率 (P<0.001) 。结论 ³²P敷贴治疗对草莓状血管瘤与鲜红斑痣具有较理想的临床效果。患者年龄对皮肤血管瘤³²P敷贴治疗疗效有明显影响,年龄越小,疗效越好。皮肤血管瘤类型中³²P敷贴治疗以草莓状血管瘤疗效好于鲜红斑痣。患者性别与病灶数目和部位对³²P治疗疗效无明显影响。湘雅二医院核医学科刘国锋

关键词：32磷, 草莓状血管瘤, 鲜红斑痣, 敷贴治疗

The clinical analysis of 538 cases cutaneous hemangioma with radionuclide ³²P treatment LIU Guo-feng Wang Yunhua JING Ningyi ,et al. Department of Nuclear Medicine, Second Xiangya hospital,

Central South University,Changsha 410011,China

[Abstract] Objective To study the therapeutic radionuclide ³²P Sticking strawberry hemangioma, port-wine stains two kinds of skin hemangioma effect. Explore the patient"s age, sex, disease site and type of vascular tumors and other factors on the impact of ³²P Sticking therapy. Methods of skin in patients with a total of 538 cases of hemangioma, will be affixed to the ³²P film with skin hemangioma Department, according to the size and age, children with vascular lesions Dressing tumor growth site to determine the time. Results of age on the ³²P treatment effect had a significant effect Applicator (P <0.001), ≤ 6 months, groups of skin capillary hemangioma treatment efficiency was significantly higher than "June groups (P <0.001). ³²P treatment efficiency of different gender difference was not statistically significant (P> 0.05). Single-site and multiple sites hemangioma cases of therapeutic efficacy with no significant difference (P> 0.05).Of different types of vascular tumors, ³²P Sticking significant difference in treatment effect, strawberry hemangioma treatment efficiency was significantly higher than the efficiency of treatment of port-wine stains (P <0.001). Conclusion ³²P  Sticking treatment on strawberry hemangioma with port-wine stains with a more satisfactory clinical results. Patient"s age on the skin hemangioma ³²P Sticking therapy had a significant effect, the younger the better curative effect. Skin hemangioma type ³²P Sticking with strawberry hemangioma treatment more effective than PWS. Lesions in patients with gender and the number and location of the ³²P therapy had no significant effect.

[Key words] ³²P, strawberry hemangioma , port-wine stains , Applicator treatment

皮肤血管瘤是起源于皮肤毛细血管的良性肿瘤^[1～2] ,起源于中胚叶。 多在婴儿出生时或出生后不久出现，部分患者可在1岁左右停止生长^[3]　，皮肤血管瘤多见于颜面、四肢,在婴幼儿躯干部也占了一定的比例。据文献资料统计,新生儿患病率为3% ～8%,至1岁时可高达10% ～12%,可多发^[4～6]。因此,对于血管瘤应该早期治疗,以控制它的生长,促进消退^[7]。我们对2007年至2009年用³²P简易敷贴药膜治疗皮肤血管瘤患者538例，现报道如下。

资料与方法

1．病例选择。对2007年至2009年³²P治疗皮肤血管瘤患者共538例，男性142例，女性396例，年龄：1月～30岁，平均年龄1.4±3.0岁。其中①草莓状血管瘤患者341例，其中男性92例，女性249例。②鲜红斑痣患者197例，其中男性50例，女性147例。

排除对象①海绵状血管瘤患者。②混合型血管瘤患者。③³²P治疗前，经过其它方法治疗的血管瘤患者。④³²P敷贴治疗6次以上的患者。

2.材料：³²P (Na₂H³²P O4)载体溶液,由北京原子高科公司提供。纯度>98%。物品:滤纸、塑料薄膜、记号笔、剪刀、小镊子、透明面积测量格纸、烤灯等。

3. ³²P 敷贴药膜的制备。选择干净优质的滤纸,厚度约1.3mm,按0.925MBq/cm²的浓度治疗要求将Na₂H³²P O4溶液用水稀释.根据预先印好的血管瘤的大小将³²P均匀在滴在滤纸上,使滤纸刚湿透为宜,然后烘干并用簿膜密封。

4. ³²P 敷贴治疗方法。将³²P敷贴药膜贴于皮肤血管瘤处,用防过敏胶布将其固定牢靠,根据患儿年龄大小及血管瘤生长部位确定病变敷贴时间（敷贴时间8～45h）。如需再次敷贴,治疗间隔时间为2～3个月。不同年龄患者每次敷贴时间见表1。

 

表1不同年龄患者每次敷贴时间（h）、吸收剂量（Gy）