得保松联合甲氨蝶呤注射治疗婴幼儿血管瘤

Injection of Diprospan with Methotrexate (MTX) in the treatment of infantile hemangioma

目的:探索得保松联合甲氨蝶呤综合注射治疗婴幼儿血管瘤的安全有效、创伤小的方法。方法:应用瘤体间质内得保松混合甲氨蝶呤注射,或栓塞硬化结合得保松混合甲氨蝶呤注射治疗表浅和深部血管瘤。结果:治疗婴幼儿血管瘤共178例。皮肤的浅表血管瘤经间质内得保松及甲氨蝶呤注射治疗102例,其中共1次注射治疗消退38例,共2次治疗消退45例,共3次治疗消退19例,无1例出现皮肤破溃。深部血管瘤经栓塞硬化联合得保松混合甲氨蝶呤注射治疗72例,其中共1次治疗消退62例,共2次治疗消退10例。血管瘤合并KM综合征4例,共1次治疗2例,共2次治疗2例血小板恢复正常,瘤体消退,无复发;栓塞硬化治疗中3例出现皮肤水泡及部分皮肤干性坏死,均自行愈合。结论:得保松联合甲氨蝶呤瘤体间质注射或结合栓塞硬化注射治疗婴幼儿血管瘤,能够控制其快速生长,其疗效安全可靠,创伤小,形态功能恢复良好,具有美容效果。

Objective To explore a safe, effective and minimally invasive therapy of infantile hemangioma with the combined injection of Diprospan plus Methotrexate （MTX）. Methods Apply the injection of Diprospan with MTX in interstitial tissue of the hemangioma, or combine with the embolo-sclerotherapy and Diprospan plus MTX according to the depth of lesion （deep or superficial）. Results 178 patients with infantile hemangioma were treated. 102 superficial lesions involving skin layers had injection of Diprospan with MTX into interstitial tissue, among which 38 patients＇ lesions decreased after 1 injection, 45 cases decreased after 2 injections, 19 cases decreased after 3 times of treatment, with no case of skin ulceration. 72 deep lesions had combined embolo-sclerotherapy with Diprospan plus MTX,among which 62 patients＇ lesions decreased after 1 injection, 10 cases decreased after 2 injections. 4 cases of Kasabach -Merritt Syndrome （KMS）： 2 cases had 1 injection and other 2 had 2 injections, all showed good results with platelet count back to normal, lesions disappearance and no recurrence. 3 deep lesions got skin blisters and local dry necrosis after treatment and all healed up spontaneously. Conclusion The injection of Diprospan with MTX,or a combination of embolo-sclerotherapy and Diprospan plus MTX in treating infantile hemangioma can well control the growth of the lesion. It＇s a safe, effective, minimally invasive way to retain form and function, and also provides an aesthetic effect.