婴幼儿血管瘤的治疗策略与经验

Q4 Medicine
V. Rybalchenko, A. Pereyaslov, I. Rybalchenko, O. Nykyforuk
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引用次数: 0

摘要

客观的分析不同方法治疗婴幼儿血管瘤的疗效。方法。该研究基于2000-2018年期间婴儿血管瘤儿童(n=189)的治疗结果。将所有患者分为以下组:1)动态观察23例(12.2%)儿童;2) 局部破坏-78(41.3%);3) 手术治疗-22例(11.6%);4) 药物治疗66例(34.9%)。局部破坏采用间质凝固(n=28)和血管瘤电凝(n=50)。18例患者接受了血管瘤的完全切除和肿瘤的4节段切除,随后接受普萘洛尔治疗。普萘洛尔用于药物治疗,并与噻吗洛尔的局部应用相结合(n=13)。后果第一组中有18例(78.3%)患者出现血管瘤消退。在第二组患者中,26例(92.6%)患者在应用间质凝固时观察到血管瘤消退,2例(7.4%)儿童血管瘤复发。对浅表血管瘤(所有患者)进行电凝治疗可达到很强的积极效果。通过一级根治性干预,所有儿童都完全治愈,而通过节段切除,只有一名(4.5%)儿童复发。3例(13.6%)患儿术后出现瘢痕疙瘩。普萘洛尔似乎对所有年龄段的儿童血管瘤都有效,41例(62.1%)患者的血管瘤完全消失。结论在开始治疗之前,需要评估儿童的禁忌症和治疗策略。如遇婴幼儿血管瘤,应根据临床调查结果进行个体化。系统性普萘洛尔治疗作为婴儿血管瘤的首选治疗方法已迅速普及,不仅可以作为基础治疗,还可以与其他方法相结合。血管瘤的外科切除仍然是儿童血管瘤的常见治疗组成部分之一。本文对婴儿血管瘤治疗的不同变体进行了分析:从动态观察到手术和全身治疗。研究表明,对于婴儿血管瘤,在没有禁忌症的情况下,β受体阻滞剂已成为首选治疗方法;手术治疗适用于有并发症发展风险的儿童。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
STRATEGY AND EXPERIENCE OF INFANTILE HEMANGIOMA TREATMENT
Objective. To analyze the treatment results of patients with infantile hemangiomas using various methods. Methods. The study is grounded on the treatment results of children (n=189) with infantile hemangiomas during the period of 2000-2018 years. All patients were divided into the groups: 1) dynamic observation - 23 (12.2%) children; 2) local destruction - 78 (41.3%); 3) surgical treatment - 22 (11.6%); 4) drug therapy - 66 (34.9%) patients. The interstitial coagulation (n=28) and electrocoagulation of hemangioma (n=50) were applied for the local destruction. 18 patients underwent the complete removal of hemangioma and 4 - segmental resection of tumor with the subsequent propranolol treatment. Propranolol was used for the drug treatment and it was combined with the topical application of timolol (n=13). Results. Hemangioma regression was registered in 18 (78.3%) patients of the first group. Among the patients of the second group, involution of hemangioma was observed in 26 (92.6%) patients when the interstitial coagulation was applied and 2 (7.4%) children had hemangioma recurrence. A strongpositiveeffect can be reached by electrocoagulation of superficial hemangiomas (all patients). With primary radical intervention, complete cure was noted in all children, and with segmental resection only one (4.5%) child had a relapse. Keloid scars were formed in 3 (13.6%) children after surgery. Propranolol seemed to be effective in treating hemangiomasinchildrenof all ages, and in 41 (62.1%) patients hemangiomas completely disappeared. Conclusion. Before initiatingtherapy, thechildrenneed to be assessed for the contraindications and the treatment strategy.In case of infantile hemangioma should be individual based on the results of clinical investigation. Systemic propranolol treatment has gained rapid popularity as the treatment of choice for infantile hemangiomas and may be applied not only as the basic treatment, but also in combination with other methods. Surgical removal of hemangioma remains one of the common treatments components for children with infantile hemangiomas. What this paper adds Different variants of infantile hemangioma treatment have been analyzed: ranging from dynamic observation to surgical and systemic treatment. It has been shown, that in case of infantile hemangiomas, Beta-blockers have become the treatment of choice in case of the absence of contraindications; and surgical treatment is indicated in children with the risk of complications development.
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来源期刊
Novosti Khirurgii
Novosti Khirurgii Medicine-Surgery
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