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目的:通过使用平阳霉素局部灌注来观察其对术后淋巴管漏的防治效果。方法:按照随机数字表法将111例患儿分为对照组、高浓度灌注组和低浓度灌注组,各组均先行手术切除肿瘤。低浓度灌注组46例,高浓度灌注组40例,对照组24例,分别将平阳霉素用生理盐水稀释为0.5、1 mg/ml,单次剂量不超过8 mg,保留10~15 min后开放引流,任灌洗液流出,予加压包扎。每天灌注1次,隔天进行,连续灌注2次。对照组仅予以负压引流及加压包扎。结果:与对照组比较,低浓度灌注组和高浓度灌注组淋巴管漏发生率均大幅度降低(P<0.05),而低浓度灌注组与高浓度灌注组比较差异无统计学意义(P>0.05)。平阳霉素灌注组发生淋巴管漏的例数远远低于未灌注组,且发生淋巴管漏后予以再次灌注1~2次后均治愈。而对照组19例淋巴管漏患儿,除4例经2周左右持续负压引流及加压包扎后自愈,15例经2周以上持续负压引流及加压包扎后仍未愈,最后均予以平阳霉素灌注后治愈。低浓度灌注组与高浓度灌注组相比较,其局部硬结形成例数较少(P<0.05)。结论:使用低浓度平阳霉素行局部创面灌注,不仅可减少淋巴管瘤术后淋巴管漏的发生,还可以降低药物灌注的副作用,可作为淋巴管瘤术后常规灌注使用,以减少淋巴管漏的发生,提高治疗的满意度。
Objective: To observe the effect of prevention and treatment of postoperative lymphatic leakage by using Pingyangmycin local perfusion. Methods: According to the random number table method, 111 children were divided into control group, high concentration perfusion group and low concentration perfusion group. Each group was surgically removed tumor. 46 cases of low concentration perfusion group, 40 cases of high concentration perfusion group, 24 cases of control group, respectively, Pingyangmycin diluted with physiological saline 0.5,1 mg / ml, a single dose of not more than 8 mg, retained 10 ~ 15 min Open drainage, any irrigation fluid outflow, to pressure dressing. Perfusion 1 times a day, the next day, continuous perfusion 2 times. The control group only to negative pressure drainage and pressure bandaging. Results: Compared with the control group, the incidence of lymphatic leakage in the low-concentration group and the high-concentration group significantly decreased (P <0.05), while there was no significant difference between the low-concentration group and the high-concentration group (P> 0.05). The incidence of lymphatic vessel leakage in the pingyangmycin infusion group was much lower than that in the non-perfusion group, and was cured after lymphatic leakage and reperfusion 1 or 2 times. The control group of 19 cases of children with lymphatic leakage, in addition to 4 cases after 2 weeks of sustained negative pressure drainage and pressure bandaging after the self-healing, 15 cases of more than 2 weeks of continuous negative pressure drainage and pressure bandage still unhealed, and finally Pingyangmycin were given after the cure. Compared with the high-concentration perfusion group, the number of local induration was lower in the low concentration perfusion group (P <0.05). Conclusion: The local wound perfusion with low concentration of pingyangmycin can not only reduce the occurrence of lymphangioma after lymphangioma, but also reduce the side effects of drug infusion. It can be used as routine perfusion after lymphangioma to reduce the lymphatic vessels Leakage occurs, improve the satisfaction of treatment.