彩色多普勒超声对婴儿血管瘤疗效及预后价值分析

The Value of Color Doppler Ultrasonography in the Treatment and Prognosis of Infantile Hemangioma

目的评估彩色多普勒超声(简称彩超)在婴儿血管瘤治疗及预后价值。方法收集2018年1月至2019年1月在皮肤科门诊就诊的225例婴儿血管瘤患儿,按照初诊局部彩超瘤体深度分4组。瘤体深度<1.2 mm为A组,根据家属意愿分为外用卡替洛尔滴眼液A1组,非外用药治疗A2组;瘤体深度1.2~3 mm为B组;瘤体深度3~6 mm为C组;深度>6 mm为D组。A2、B、C、D组均采用激光治疗,在激光治疗瘤体仍增长过快时采用聚桂醇注射或口服普萘洛尔治疗,至瘤体消退或停止生长为治疗终点,并随访至2岁。比较4组激光治疗次数。结果4组患儿瘤体最终均达到治愈标准。其中A1组有7例患儿改用激光治疗;A2组、B组激光治疗均能痊愈;C组5例改用聚桂醇注射治疗,1例口服普萘洛尔治疗;D组16例改用聚桂醇注射治疗,2例改为口服普萘洛尔治疗。A2、B、C、D组激光治疗次数差异有统计学意义。A2组血流信号不同,激光次数差异有统计学意义;B组瘤体部位不同,激光次数差异有统计学意义。结论对未经治疗的婴儿血管瘤患儿初诊时做彩色多普勒超声检查,根据彩超的深度及CDFI血供情况、瘤体部位及年龄,可初步评估可行治疗方案,预估平均激光治疗次数。

Objective To evaluate the value of color Doppler ultrasound in the treatment and prognosis of infantile hemangioma.Methods A total of 225 children with infantile hemangioma who visited dermatology outpatient department from January 2018 to January 2019 were collected and divided into 4 groups according to the depth of color Doppler ultrasound initial diagnosis.The tumor depth was<1.2 mm in group A,which was divided into group A1 for external use of carteolol eye drops and group A2 for non-external treatment according to the will of parents.The tumor depth 1.2-3 mm was group B,and the tumor depth 3-6 mm was C group.The depth>6 mm was group D.Group A2,B,C and D were all treated with laser therapy.As the tumor was still growing too fast after laser treatment,lauromacrogol injection or oral propranolol was used to treat the tumor until its regression or cessation of growth.The frequency of laser treatment was compared among the four groups.Results The 4 groups were cured.In group A1,7 children changed to laser treatment;Group A2 and group B were cured by laser treatment.In group C,5 patients were treated with lauromacrogol injection and 1 patient was treated with oral propranolol.In group D,16 patients were treated with lauromacrogol injection,and 2 patients were treated with oral propranolol.The difference of average laser treatment times in group A2,B,C and D was statistically significant.The blood flow signal of A2 group was different,and the difference of laser frequency was statistically significant.The number of laser frequency in group B was statistically significant in different tumor sites.Conclusion For untreated infantile hemangioma children,color Doppler ultrasound examination at the first diagnosis,according to the depth of color doppler ultrasound,CDFI,tumor site and age,can initially evaluate the feasible treatment plan,and estimate the average number of laser treatment.