[婴儿淋巴畸形的治疗:单中心经验]。

中华整形外科杂志 Pub Date : 2017-03-01
Tao Han, Jijun Zou, Haini Chen, Yi Ji, Jianbing Chen, Weimin Shen, Jie Cui
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引用次数: 0

摘要

目的:探讨小儿淋巴畸形(LM)的治疗效果。方法:本回顾性研究纳入我院2004年6月至2015年7月996例LM患者的临床资料。所有患者均经超声、CT或MR扫描诊断为LM。所有患者分为1组(427例,经内镜下LM部分切除联合烧灼及术后瘤内负压和无水乙醇治疗)、2组(239例,联合注射品阳霉素和地塞米松治疗)、3组(330例,单纯手术切除)。观察三组患者的临床疗效,分析颈面部LM在性别、年龄、最大直径、部位、范围、组织学分型、淋巴性质及治疗方法等方面的疗效差异。结果:1组治愈333例(78.0%),2组治愈165例(69.0%),3组治愈238例(72.1%)。1组与2组、3组治愈率比较,差异均有统计学意义(P <0.05)。第3组接受≥2种治疗的患者数量明显少于其他两组。颈面部LM的治愈率显著低于身体其他部位(P < 0.05)。颈面部LM患者在最大直径、范围、组织学分型、淋巴性质等方面的疗效差异均有统计学意义(P < 0.05)。在多变量logistic回归分析中,LM范围和组织学分型是影响疗效的独立因素(P < 0.05)。结论:内镜下LM部分切除联合烧灼及术后瘤内负压无水乙醇治疗和手术切除对婴幼儿LM均有较好的治疗效果。LM范围和组织学分型是影响婴幼儿颈面LM治疗效果的重要独立因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Management for lymphatic malformation in infants: a single center experience].

Objective: To assess the therapeutic effect of management for lymphatic malformation (LM) in infants.

Methods: This retrospective study recruited clinical data of 996 patients with LM from June 2004 to July 2015 in our center. All patients were diagnosed as LM after ultrasound, CT or MR scan. All patients were divided into Group 1 (427 patients, treated by endoscopic LM partial resection combined with cautery and postoperative intratumoral negative pressure and absolute ethyl alcohol),Group 2 (239 patients, treated by combined pinyangmycin and dexamethasone injection),Group 3 (330 patients, treated by surgical resection only).The clinical effects were observed in three groups, and therapeutic effect differences in gender, age, maximum diameter, location, range, histological typing, lymph property and treatments were analysed in cervicofacial LM.

Results: Group 1:333 patients were cured (78.0%),Group 2:165 patients were cured (69.0%),Group 3:238 patients were cured (72.1%).The difference in cure rate between Group 1 and Group 2 or between Group 1 and Group 3 was significant(P <0.05).The number of patients with ≥ 2 treatments in Group 3 was significantly less than that in other two groups. The cure rate of LM in cervicofacial area was significantly lower than that in other parts of body (P < 0.05).In cervicofacial LM patients, the therapeutic effect differences in maximum diameter, range, histological typing, lymph property were statistically significant (P < 0.05).At the multivariable logistic regression analysis, LM range as well as histological typing were independent factors influencing the therapeutic effect (P < 0.05).

Conclusions: Both treatment of endoscopic LM partial resection combined with cautery and postoperative intratumoral negative pressure and absolute ethyl alcohol, and surgical resection have good therapeutic effect on LM in infants. LM range as well as histological typing are important factors independently influencing the therapeutic effect of cervicofacial LM in infants.

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