聚桂醇局部注射对不同年龄和部位小儿血管瘤的疗效分析

doi:10.3969/j.issn.1009-976X.2021.02.014

摘要/Abstract

摘要： 目的探讨聚桂醇注射治疗小儿血管瘤的疗效。方法回顾性分析2014年6月~2019年6月间,在江门市妇幼保健院小儿外科收治的体表血管瘤患儿90例,给予多点注射聚桂醇治疗,采用Achauer疗效评价方法进行评估,记录瘤体面积变化、取得疗效所需的时间及并发症。结果聚桂醇第一疗程总体有效率95.56%,第二疗程有效率可达100%,其中头面颈部的体表血管瘤起效最快,年龄越小效果越好。四肢的血管瘤并发症最高,达5.56%;肿胀和疼痛是最常见的并发症。结论聚桂醇局部注射治疗小儿血管瘤取得良好的临床效果,疗程短且并发症发生率低,可广泛应用于小儿体表血管瘤的治疗。

关键词: 血管瘤, 儿童, 聚桂醇, 疗效

Abstract: Objective To investigate the clinical efficacy of lauromacrogol injection in the treatment of hemangioma in children. Methods From June 2014 to June 2019, 90 patients diagnosed with superficial hemangioma in department of pediatric surgery, Jiangmen Maternal and Child Health Hospital were analyzed retrospectively. All of them were given lauromacrogol injection therapy. Achauer standard methods were applied to clinical effect assessment. The size of tumor, the clinical efficacy and side effects of the patient were recorded and analyzed. Results The total effective rate in the first course treatment of lauromacrogol was 95.56%, and the second course treatment was up to 100%. The superficial hemangioma in head and neck had better effects, and the younger children also had showed better therapeutic effects. The complications of hemangioma surgery in the extremities were the highest （5.56%）, in which swelling and pain were the most common. Conclusion Local injection of lauromacrogol in treatment of hemangioma in children has good clinical efficacy. The course of treatment is short and the incidence of complications is low. It can be widely used in the treatment of hemangioma in children.

Key words: hemangioma, childern, lauromacrogol, efficacy

中图分类号:

R732.2

周克燕, 胡景辉, 刘东彪, 文健辉, 关飞. 聚桂醇局部注射对不同年龄和部位小儿血管瘤的疗效分析[J]. 岭南现代临床外科, 2021, 21(02): 200-203.

ZHOU Ke-yan, HU Jing-hui, LIU Dong-biao, WEN Jian-hui, GUAN Fei. Clinical experience of local injection of lauromacrogol in the treatment of hemangioma in children[J]. Lingnan Modern Clinics In Surgery, 2021, 21(02): 200-203.

参考文献

[1] Chen XD, Ma G, Chen H, et al.Maternal and perinatal risk factors for infantile hemangioma: a case-control study[J]. Pediatr Dermatol, 2013, 30(4):457-461.
[2] 张世仁,仇雅璟,蔡宜佐,等. 婴幼儿血管瘤瘤体内注射药物治疗研究进展[J]. 中华整形外科杂志,2019,35(2):201-204.
[3] Phung TL, Hochman M.Pathogenesis of infantile hemangioma[J]. Facial Plast Surg, 2012, 28(6):554-562.
[4] Chai Y, Zhou Z, Song J, et al.Safety of intralesional injection of lauromacrogol combined with triamcinolone for infantile hemangiomas[J]. J Dermatol, 2019, 46(9): 770-776.
[5] López-Gutiérrez JC.Clinical and economic impact of surgery for treating infantile hemangiomas in the era of propranolol: overview of single-center experience from La Paz Hospital, Madrid[J]. Eur J Pediatr, 2019, 178(1):1-6.
[6] Gao Z, Zhang Y, Li W, Shi C.Effectiveness and safety of polidocanol for the treatment of hemangiomas and vascular malformations: A meta-analysis[J]. Dermatol Ther, 2018, 31(1): 10.
[7] Darrow DH, Greene AK, Mancini AJ, et al.Diagnosis and Management of Infantile Hemangioma: Executive Summary[J].Pediatrics, 2015, 136(4):786-791.
[8] 吴奇,李养群. 婴幼儿血管瘤的发生机制及治疗研究进展[J]. 医学综述,2018,24(21):4270-4275.
[9] Ceisler EJ, Santos L, Blei F.Periocular hemangiomas: what every physician should know[J]. Pediatr Dermatol, 2004, 21(1):1-9.
[10] Tal R, Dotan M, Lorber A.Approach to haemangiomatosis causing congestive heart failure[J]. Acta Paediatr, 2016, 105(6):600-604.
[11] Hogeling M, Adams S, Wargon O.A randomized controlled trial of propranolol for infantile hemangiomas[J]. Pediatrics, 2011, 128(2): e259-e266.
[12] Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, et al.A randomized, controlled trial of oral propranolol in infantile hemangioma[J]. N Engl J Med, 2015, 372(8): 735-746.
[13] Bennett ML, Fleischer AB Jr, Chamlin SL, Frieden IJ.Oral corticosteroid use is effective for cutaneous hemangiomas: an evidence-based evaluation[J]. Arch Dermatol, 2001, 137(9):1208-1213.
[14] Perez J, Pardo J, Gomez C.Vincristine--an effective treatment of corticoid-resistant life-threatening infantile hemangiomas[J]. Acta Oncol, 2002, 41(2): 197-199.
[15] Michaud AP, Bauman NM, Burke DK, et al.Spastic diplegia and other motor disturbances in infants receiving interferon-alpha[J]. Laryngoscope, 2004, 114(7): 1231-1236.
[16] Itinteang T, Brasch HD, Tan ST, Day DJ.Expression of components of the renin-angiotensin system in proliferating infantile haemangioma may account for the propranolol-induced accelerated involution[J]. J Plast Reconstr Aesthet Surg, 2011, 64(6):759-765.
[17] Zaher H, Rasheed H, El-Komy MM, et al.Propranolol versus captopril in the treatment of infantile hemangioma (IH): A randomized controlled trial[J]. J Am Acad Dermatol, 2016, 74(3):499-505.
[18] Winter H, Dräger E, Sterry W.Sclerotherapy for treatment of hemangiomas[J]. Dermatol Surg, 2000, 26(2):105-108.
[19] Beck DO, Gosain AK.The presentation and management of hemangiomas[J]. Plast Reconstr Surg, 2009, 123(6): 181e-191e.
[20] Grover C, Arora P, Kedar A,et al.Combination of oral corticosteroids and polidocanol sclerotherapy in the management of infantile hemangiomas[J]. Dermatol Surg, 2010, 36(12):2030-2036.