得保松和甲氨蝶呤联合注射治疗婴幼儿血管瘤67例(1)
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[摘要]目的:探讨治疗婴幼儿血管瘤有效和创伤小的方法。方法:婴幼儿血管瘤患者67例,年龄2～15月,头面部42例,颈部6例,躯干16例,四肢3例;增生期58例,消退期9例;所有病例使用瘤体间质内注射得保松与甲氨蝶呤混合液。结果:所有病例均经过0.5～2年的随访,治愈26例,基本治愈33例,好转7例,无效1例。结论:得保松联合甲氨蝶呤局部注射疗法适合于大多数血管瘤的治疗,能够控制血管瘤的生长,促进其消退,而且治疗容易,创伤小,无明显副作用。
[关键词]血管瘤;婴幼儿;得保松;甲氨蝶呤
[中图分类号]R732.2 [文献标识码]A [文章编号]1008-6455(2010)09-1352-03
Local Injection of Diprospan with Methotrexate(MTX) in the management of infantile hemangioma
LIAO Hong-yue1,OUYANG Tian-xiang2,HUANG Da-jiang1,ZHOU Jun1,LI Ying1,WU Li-cheng1,ZOU Lai-xing1
(1.Department of Plastic Surgery, Jiangxi General Hospital of Chinese People's Armed Police forceNanchang 330030,China; 2.Department of Plastic surgery, Xinhua Hospital.Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)
Abstract: Objective To study the therapy of infantile hemangiomas with effectively and minimally invasive.Methods A total of 67 patients with hemangiomas were treated by the same surgeon from September,the study ranging in age from 2 months to 15 months,among the 67 patients,42 hemangiomas were located on the head and face, 6 on the neck, 16 on the trunk,and 3 on the extremities.According to Mulliken biological cataloge,58 hemangiomas in growth stage and 9 in involution stage. Apply the injection of Diprospan with MTX in interstitial tissue of the hemangioma. ResultsAll patients were followed up for a half year to 2 years.Follow up results showed that 26 patients were cured, 33 were greatly improved,7 were partly improved,and 1 patient was noobvious improvement.Conclusions Local injection of Diprospan with MTX is suitable to for the treatment of most infantile hemangiomas,which can well control the growth of the lesion and improve to involute.1t's a easy,minimally jnvasive approach to treat hemangiomas and also provides an barelyeffect.
Key words: hemangioma;infant;diprospan;methotrexate;
血管瘤,旧称草莓状痣、单纯性毛细血管瘤,草莓状血管瘤,是婴幼儿最常见的良性肿瘤,文献统计发病率约为4%～12%,男女比例为1:3～5,早产低体重婴幼儿发病率更高[1-2]。婴幼儿血管瘤以血管内皮细胞数量异常增多以及出现自发消退为主要特征,其发生和内皮细胞自身的缺陷和外界环境因素的影响相关,但其确切发病机制仍不明确,婴幼儿血管瘤的治疗方法有多种,目前多采用类固醇激素、抗肿瘤药物治疗,不同药物治疗各有利弊。2005年9月～2009年6月,笔者局部联合运用得保松和甲氨蝶呤治疗婴幼儿血管瘤67例,取得了良好效果,现报道如下。
1 资料和方法
1.1 一般资料:本组婴幼儿血管瘤共67例,其中男19例,女48例,年龄2～15月。病变部位:头面部42例,颈部6例,躯干16例,四肢3例,所有血管瘤均位于皮肤表面,并且突出皮面,直径5～112mm。按照血管瘤分期:增生期58例,消退期9例。血管瘤诊断依据:主要依据病史和临床表现,并经彩超检查,部分病例还经穿刺活检确诊。
1.2 治疗方法:术前常规检查血细胞分析和彩超,按照血管瘤所在部位、大小和患儿体重,得保松(复方倍它米松注射液)剂量按0 ......
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