摘要
目的探讨颈外动脉置管药物灌注治疗婴幼儿口腔颌面部重症血管瘤的效果。方法选取2004年6月至2009年12月河南省人民医院收治的126例婴幼儿口腔颌面部重症血管瘤患儿。男45例，女81例；就诊年龄10d～1岁4个月，平均年龄3．9个月。其中合并Kabasach-Merritt综合征者（KMS）24例（19．1％）。采用颈外动脉置管药物灌注治疗，术后灌注400g／L尿素溶液，合并KMS者联合灌注甲泼尼龙。结果随访4．3～10．2年，平均随访6．1年。126例患儿均治愈，其中单纯采用置管药物灌注治疗治愈94例，置管药物灌注联合局部尿素注射治愈32例。治疗后瘤体逐渐缩小消失，瘤体0．5～1．0年后完全消失105例，1～2年消失2l例。24例合并KMS患儿血小板计数及凝血功能逐渐恢复正常，其中血小板计数术后3～7d恢复到正常13例，8～14d恢复到正常7例，15～30d恢复到正常4例。长期随访患儿体质量、身高、免疫力等同健康儿童发育，未见明显不良反应发生。结论颈外动脉置管药物灌注疗法治疗婴幼儿口腔颌面部重症血管瘤可明显缩短治疗时间，降低药物不良反应，有良好治疗效果，是一种较为理想的治疗方法。
Objective To explore the therapeutic effect and the efficacy of external carotid artery catheteriza- tion and drug infusion therapy for severe infant hemangiomas in oral and maxillofacial regions. Methods The clinical and follow - up data of 126 cases with severe infant oral and maxillofacial hemangiomas were retrospectively analyzed in Henan Provincial People＇s Hospital between June 2004 and December 2009. The patients included 45 male and 81 female cases, and the average visiting age of the patients was 3.9 months （ ranged 10 days to 1 year and 4 months）. A- mong 126 patients,24 cases occurred with Kasabach- Merritte syndrome （KMS）. The patients were treated with liga- tion of external carotid artery, insertion of a tube inside the lesion and injection of 400 g/L Carbonyldiamide after opera- tion. Methylprednisolone was added in infusion if the patients were combined with KMS. Results The mean follow - up period was 6.1 years （ranged 4.3 to 10.2 years）. All of 126 cases were cured through the management including exter- nal carotid artery catheterization and drug infusion therapy in 94 cases, and the combination treatment of the infusion and local Carbonyldiamide injection in 32 cases. The size of hemangiomas gradually shrank and disappeared after the therapy. The hemangiomas in 105 cases disappeared completely in 6 - 12 months, and 21 cases disappeared in 1 -2 years. Twenty - four patients were complicated with KMS. The thrombocyte count and blood coagulation function also re- turned to normal after the therapy. Among the 24 cases, the thrombocyte count in 13 cases was back to normal within 3 -7 days,and 7 cases within 8 - 14 days . In the remaining 4 cases,it normalized within 15 -30 days. The weight, height,immunity of the patients were in keeping with the healthy counterparts after long term follow - up. And no serious adverse effect was observed. Conclusions For severe infant hemangiomas in oral and maxillofacial regions, the external carotid artery catheterization and drug infusion therapy c
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第18期1432-1434,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
河南省医学科技攻关基金项目（201403152）
河南省科技攻关基金项目（112102310235）
