Efficacy And Safety Of Local Injection Of Pingyangmycin Forinfantile Hemangioma And Analysis Of Influencing Factors

Objective:This study observed the efficacy and adverse reactions of Intralesional injection of Pingyangmycin in the treatment of infantile hemangioma,and analyzed its related influencing factors.To provide some guidance for this therapy of infantile hemangioma with poor effect of first-linetreatment,and provide certain referencefor improving the safety of this therapy.Methods:A retrospective analysis was conducted on infants with hemangioma who were hospitalized in the pediatric surgery clinic of the First Affiliated Hospital of Gannan Medical university from June 2019 to June 2021.According to the inclusion criteria and exclusion criteria,41 children were selected and hospitalized for Intralesional injection of Pingyangmycin under b-ultrasound guidanc.The basic information of patients,tumor changes,imaging data and adverse reactions during treatment were recorded in detail.The children were divided into groups according to their sex,location,type of focus,tumor size and tumor blood supply.The differences in the efficacy and incidence of adverse reactions of Intralesional injection of pingyangmycin among different groups were analyzed by chi-square test,and the effects of various factors on the efficacy and incidence of adverse reactions were analyzedby logistics regression model.Results:According to the Achauer grading standard:1 case of grade Ⅰ(2.44%);6 cases of GradeⅡ(14.63%);9 cases of Grade Ⅲ(21.95%);25 cases of grade Ⅳ(60.98%).The cure rate was60.98% and the total effective rate was 82.93%.There are differences in curative effect among different types of IH children,and the curative effect of superficial type and mixed type IH children is better than that of deep type hemangioma(P<0.05).There is no significant difference in curative effect of hemangioma between different sites and sexes(P>0.05).There are differences in curative effect among IH children with different tumor diameters(P<0.05).Tumor diameters < 20 mm and ≥20.The curative effect of group < 40 mm is better than that of group ≥ 60 mm.There was significant difference in tumor PSV between effective and ineffective IH children.The tumor PSV of effective IH children was larger than that of ineffective IH children.Logistics regression analysis showed that the tumor diameter and PSV had an influence on the curative effect(P=0.023,P=0.020).A total of 14 cases had adverse reactions.Local adverse reactions: swelling pain in 10 cases(24.39%),ulcer in 3 cases(7.32%),scar 1 case(2.44%),systemic symptoms: fever in 4 cases(9.76%),gastrointestinal reaction in 3cases(7.32%).No serious adverse reactions related to pingyangmycin were found in all the children.There were significant differences in the incidence of adverse reactions among IH children with different tumor diameters(P<0.05).The incidence of adverse reactions in patients with tumor diameter ≥ 60 mm was higher than that in other groups.There was no significant difference in the incidence of adverse reactions among different sites and types of IH(P>0.05).Logistics regression analysis showed that the diameter of the tumor had an effect on the incidenceof adverse reactions(P=0.018).Conclusion:1.Local injection of pingyangmycin has a certain therapeutic effect on infantile hemangioma.Among the factors included in this study,gender and location had no significant effect on the curative effect.The curative effect of tumor diameter < 40 mm group was better than that of diameter > 60 mm group,superficial phenotypic hemangioma and mixed hemangioma group was better than deep hemangioma group,and tumor blood supply rich group was better than poor blood supply group.It is suggested that this therapy may be more suitable for children with rich blood supply of tumor,that is,partial lumen is more obvious,and thesize and typeof tumor should be considered at the same time.2.No serious adverse reactions occurred in all the children in this study.The type and location of the included factors in this study had no significant effect on the incidence of adverse reactions,but the diameter of the tumor may be the influencing factor of the incidence of adverse reactions.Children with large tumor diameter should avoid single high-dose injection,and low-dose multiple injection should be recommended to reduce the occurrence of related adverse reactions.