小儿体表海绵状血管瘤的诊断及局部注射治疗

The Diagnosis And Treatment of Local Injection For Superficial Cavernous Hemangioma Among Children

目的总结彩色多普勒B型超声、增强CT及三维立体重建影像检查对血管瘤诊断的意义,比较地塞米松、平阳霉素瘤内注射治疗小儿浅表海绵状血管瘤的疗效。方法选取1995年～1999年浅表海绵状血管瘤80例为A组,瘤内注射地塞米松;2000年～2005年80例为B组,瘤内注射平阳霉素。两组均每1～2周注射1次,共注射2～6次不等,直至肿物不再缩小。两组患儿年龄2个月～10岁,男∶女≈1∶3。全部病例均通过病史、体格检查及彩色多普勒B超确诊。部分行增强CT及三维立体重建影像检查进一步明确血管瘤的大小、形态、位置、血流及与周围血管的关系。结果A、B两组治愈率分别为75%、92.5%,好转率为25%、7.5%,总有效率均为100%。平阳霉素组治愈率明显高于地塞米松组。全部病例无明显瘢痕形成。A组78%出现肥胖、多毛等,停药后恢复正常;B组注射后发热、腹泻、皮疹的发生率分别为47.5%、22.5%、7.5%,经对症处理后恢复正常,无肺炎样症状、肺纤维化及过敏发生。结论平阳霉素瘤内注射治疗小儿浅表海绵状血管瘤疗效满意,是治疗小儿浅表海绵状血管瘤的首选方法。

Objective To study the role of B-ultrasonography and 3-dementional CT-angiography in the diagnosis and to compare the both therapeutic effects of the injection to tomor mass inside with dexamethasone and pingyangmycine(Bleomycin)for superficial cavernous hemangioma among suffered children.Methods Clinical records of the mentioned hemangioma underwent the two drugs injection to tumor mass inside treatment was retrospectively studied.80 of them was selected as group A;who received Dexamethasone,injections in the years of 1995 ～ 1999,another 80 was selected as group B who received Bleomycin in 2000 ～ 2005.Other conditions of both groups were comparable,including:age ranged from 2 mos to 10 yrs.,and sex ratio being one male to 3 females.Diagnosis of all cases were carried out by clinical signs and B-ultrasonography,but some by additional 3-dementional CT angiography for related detail structures.Drugs were given by intra-tumor injections,1 ～ 2 times weekly for 2 ～ 6 times until the regression remained stable.Results The cure rates were 75.0% in group A and 92.5% in group B;semi-cures in other 25.0% and 7.5% respectively.The total effectiveness rate was 100% in both groups.There was no remarkable scar formation or other complication.Evidently,Bleomycine group showed its superiority in cure rate.Conclusions For superficial cavernous hemangioma,with Bleomycin injection to tumor mass inside is preferred as the treatment of first choice.