复方倍他米松局部注射控制性治疗婴幼儿真性血管瘤

The controllable therapy of infantile hemangioma by local injection with compound betamethasone preparation （Diprospan ）

目的探讨局部注射得保松（复方倍他米松注射液）治疗婴幼儿真性血管瘤的疗效。方法本组患者25例，瘤体面积1cm×1cm～8cm×8cm。初次治疗年龄为1～7个月。根据瘤体大小，初次注射得保松剂量1～2ml，以注射用水1～2ml稀释，在瘤体顶部和边缘向瘤体中心注射3～5针，共2～4ml，注射后每月随访一次。如瘤体持续消退，则无须再次注射；如瘤体有再次生长扩大的趋势，需要重复注射。随访至1岁后，改为不定期随访。结果①治疗后1个月，瘤体变柔软、平坦，颜色变为暗红色，大部分瘤体从中心部分开始消退。②治疗后2个月，部分较小瘤体基本消退；部分较大瘤体持续消退，可继续观察；少部分瘤体可在边缘再次增生，需要再次注射。③从初次就诊至1岁，需要1—3次治疗，大部分瘤体基本消退，少部分体积较大的瘤体也明显萎缩。部分患者随访至2岁，瘤体外观平坦，无纤维脂肪增生所致的局部肥大，仅遗留局部毛细血管扩张。④治疗后短期可见短暂的、可逆的局部皮肤萎缩，无其他并发症。结论复方倍他米松注射液用于局部早期真性血管瘤的治疗，可以获得较好的治疗效果。

Objective To explore the clinical effect of infantile hemangioma by local injection with compound betamethasone preparation （Diprospan ）. Methods Twenty-five patients with infantile hemangioma were included in this clinical study. The size of tumors ranged from 1 cm× 1 cm to 8 cm× 8 cm. The ages of patients in the first treatment were from 1 - 7 months old. Injeetive dosage firstly was 1 ml to 2 ml Diprospan diluted with 1 ml to 2 ml aqua pro injectione according to the tumor sizes, injections were performed from the top and margin to the center of tumor with 3 -5 injections. The follow-up interval was 1 month. If hemangioma continued to regress, we just observed it. If hemangioma tended to enlarge again, we made the second injection. All of the follow-up lasted for at least 1 year. Results （1） The hemangioma became soft, flatten and faint at 1 month after treatment. The regression in the central area of tumor was obvious. （2） Some small hemangiomas almost regressed; Some bigger hemangiomas continued regressing which needed to be observed; the other much bigger hemangiomas tended to enlarge again which neened the second injeetion at 2 months after treatment. （3） The regression of most hemangiomas needed one to three times injection from the first visit to 1 year. After two years follow-up, the hemangiomas in some patients looked flat with local telangiectasia, without the local hypertrophy caused by the hyperplasia of fibrofatty tissue. （4） There were no complications except temporal and reversible local atrophy shortly after treatment. Conclusion The local injection of compound betamethasone preparation is a good choice for the small-sized hemangioma. Satisfing results can be acquired with the early treatment.