口腔颌面部血管瘤治疗的研究进展

Research progress on the treatment of oral and maxillofacial hemangioma

血管瘤是婴幼儿最常见的血管源性良性肿瘤,60%发生于口腔颌面部。口腔颌面部血管瘤具有自发性消退的特点,而少数肿瘤可出现溃疡、功能障碍、毁容等并发症,需要进行积极治疗。目前治疗口腔颌面部血管瘤的方法主要包括药物治疗、激光治疗以及手术治疗。其中用于治疗血管瘤的药物主要包括:β受体阻滞剂、糖皮质激素、干扰素α、咪喹莫特和抗肿瘤药物等;药物治疗适用于多发性、快速增殖期以及影响重要器官功能或危及生命的血管瘤。激光治疗可应用于暴露部位且快速增长的血管瘤的早期治疗。手术治疗适用于出现严重并发症的增殖期血管瘤、外部畸形的重建及溃疡后疤痕的修复。联合治疗及新技术的发展为血管瘤的治疗提供新的方向,其疗效仍需进行大样本的前瞻性研究加以证明。临床医师应对血管瘤患者进行恰当地评估,针对有治疗指征的患者制定个体化的治疗方案。本文通过对不同治疗方法的疗效、作用机制、临床应用及不良反应等进行综述,期望对临床治疗提供一定的参考作用。

Hemangioma is the most common vascular benign tumor in infants and young children,60% of which occur in the oral maxillo-facial region.One characteristic of oral and maxillofacial hemangioma is spontaneous regression,which generally does not require treatment;however,a few hemangiomas can produce complications including ulceration,functional disorders and disfigurement,which require active treatments.Currently,the treatment of oral and maxillofacial hemangioma include drug treatment,laser treatment and surgical treatment.The drugs used to treat hemangioma mainly include beta blockers,glucocorticoids,alpha-interferon,imiquimod and antitumor drugs.Drug therapy is suitable for multiple,rapidly proliferating hemangiomas and hemangiomas that affect vital organ function or endanger life.Laser therapy can be applied to the early treatment of rapidly growing hemangiomas at exposed sites.Surgical treatment is suitable for proliferative hemangioma with serious complications,the reconstruction of any external deformity and the repair of a scar after an ulcer.Combined therapy and the development of new technologies provide new directions for the treatment of hemangioma but the efficacy remains to be proven by large sample prospective studies.Clinicians should appropriately evaluate the patients with hemangioma and develop individualized treatment programs for patients with treatment indications.This article reviews the efficacy,mechanism,clinical application and adverse reactions of different treatment methods and provides references for clinical treatment.