婴幼儿血管瘤的局部医源性并发症

Topical iatrogenic complications of infantile hemangioma

目的综合讨论婴幼儿血管瘤的各种治疗方案及其并发症,以辅助临床优化治疗决策。方法2011年至2021年,于本院就诊的32名婴幼儿血管瘤患者,按治疗方式的不同分为糖皮质激素注射组、博来霉素注射组、激光治疗组、冷冻治疗组、外用β受体阻滞剂组和放疗组,评估治疗过程中的副作用和不良事件。结果几乎所有治疗均导致病灶区域瘢痕愈合。轻型并发症如疼痛、水肿、色素沉着等多见于激光治疗;重型并发症如溃疡、发育不良等在放疗组及博来霉素注射组发生率更高。外用β受体阻滞剂是相对安全的治疗方式。结论婴幼儿血管瘤治疗方案应根据儿童年龄、病灶大小和位置、并发症类型、医疗设备条件等综合考虑并谨慎实施。

Objective To explore the complications of topical treatment in children with infantile hemangioma(IH),so as to provide a framework for clinical decision-making.Methods From 2011 to 2021,a total of 32 patients with IH were retrieved from medical databases and were divided into 6 different treatment groups:intralesional glucocorticoids injection group,bleomycin injection group,laser therapy group,topicalβblockers group,cryotherapy group and radiotherapy group.Side effects and adverse events of therapies were described and discussed.Results Almost all treatments resulted in scar healing.Light complications such as significant pain,edema,hyperpigmentation were more common in laser therapy group,whereas severe complications such as ulceration and dysplasia were more common in radiotherapy group and bleomycin injection group.The most promising and safe topical treatment option was the topicalβblockers.Conclusion Therapeutic regimens for IH should be selected cautiously based on the child’s age,the size and location of the lesion,the presence of complications and the implementation conditions.