血管瘤和血管畸形临床治疗分析(附381例报告)

Clinical management of hemangiomas and vascular malformations:an analysis of 381 cases

目的：探讨血管瘤和血管畸形的治疗方法。方法：从1998年1月至2006年6月,我们共收治了381例血管瘤和血管畸形患者,男性167例,女性214例,年龄1～78岁（中位年龄16岁）,按照Mulliken的血管病变生物学分类：血管瘤98例,毛细血管畸形38例,静脉畸形203例,动静脉畸形27例,淋巴畸形15例。98例血管瘤患者中有71例进行局部激素注射治疗,20例手术切除,7例动态观察;203例静脉畸形患者中136例进行了栓塞硬化治疗,21例手术切除,11例采用栓塞硬化＋手术切除;27例动静脉畸形患者分别采用栓塞硬化、介入治疗和栓塞硬化＋手术切除的综合疗法;15例淋巴畸形患者采取栓塞硬化＋手术切除的方法。结果：所有病例经过0.5～6年的随访,治愈199例,基本治愈125例,好转46例,无效10例,死亡1例。结论：正确诊断血管瘤和血管畸形,并进行合理的分期或分类,采用合适的方法治疗血管瘤和血管畸形是提高治愈率,减少并发症的关键。

Objective：To discuss the treatment for hemangiomas and vascular malformations. Methods： A retrospective study was conducted on 381 patients with hemangiomas and vascular malformations （January of 1998 to June of 2006）. The patients consisted of 167 males and 214 females,with an age range from 1 year to 78 years （median age 16 years）. According to the biological classification system introduced by Mulliken tions,203 had venous malformations, 27 had arteriovenous in 1982,98 patients had hemangiomas,38 had capillary malformamalformations and 15 had lymphatic malformations. In all patients with hemangiomas,71 patients were treated with intralesional steroids, 20 patients underwent surgical excision, 7 patients were carefully monitored by doctors. In 38 patients with capillary malformations, 27 underwent sclerosant, others were subjected to laser therapy or surgery. In 203 patients with venous malformation,136 received sclerotherapy,21 received surgical excision,and 11 underwent sclerotherapy conjunction plus surgical excision. Twenty-seven patients with arteriovenous malformations received selerotherapy,interventional therapy,or sclerotherapy conjunction plus surgical excision. Fifteen patients with lymphatic malformations received sclerotherapy conjunction plus surgical excision. Results： All patients were followed-up for 0.5-6 years. Follow-up result showed that 199 patients were cured, 125 were greatly improved,and 46 were partly improved; 10 patients showed no obvious improvement; and 1 patient died. Conclusion： Correct diagnosis and the classification,along with correct treatment strategy, are the keys to increase the treatment outcome and decrease complication of patients with hemangiomas and vascular malformations.