儿童头面部血管瘤的治疗选择

Surgical select and cosmetic consideration for hemangioma in maxillofacial area in children

目的总结儿童头面部血管瘤的治疗选择及疗效，探索使容貌受损减少，而疗效最佳的头面部血管瘤治疗方案。方法2001～2007年本院收治192例头面部血管瘤患儿，根据瘤体大小、类型和侵犯部位的不同，采用完全切除瘤体、切除大部分瘤体加残余瘤体注射硬化剂、密集缝扎瘤体加局部注射硬化剂等治疗方法。结果192均治愈，其中一期手术治愈142例，术后继续注射硬化剂治愈42例，术后复发再次治疗8例。无一例遗留明显术后畸形。结论儿童头面部血管瘤易侵犯五官，影响容貌，宜尽寸治疗。手术治疗以不影响容貌为原则，可根据瘤体大小、部位、类型等设计切口，选择分次治疗，而不强求一次于术治疗。手术后可采用局部注射硬化剂或激光治疗残余瘤体。

Objective To summarize the surgical treatments of hemangioma in maxillofacial area in children, in order to improve the outcome and minimize cosmetic impairment. Methods Retrospective study was undertaken of 192 cases of hemangiomas of the maxillofacial region during the last 7 years. The surgical procedures included holo-resection and part-resection with sclerosing agent injection and ligation with sclerosing agent injection. Results In 192 cases, 142 cases healed on operation and 42 cases healed by injection after surgery, the remaining 8 cases were cured after a second operation. No one was left with malformation which needed reshaping. Conclusions Hemangioma in maxillofacial area in children impairs physiognomy and should be treated early. The principle of design incision and process should not have any overt cosmetic effect to the cases which were indicated for surgery. The remainder could be treat with laser or injecting sclerosmg agent.