激光联合药物血管内介入治疗婴幼儿血管瘤

目的总结激光联合疗法治疗婴幼儿血管瘤的临床疗效,探讨最佳联合治疗方案。方法各类型婴幼儿血管瘤363例,其中浅表毛细血管瘤303例,采用连续Nd:YAG激光或脉冲染料激光联合平阳霉素局部注射治疗;深部血管瘤54例,采用脉冲染料激光联合介入治疗;婴幼儿重症血管瘤6例,采用脉冲染料激光联合口服激素治疗和平阳霉素局部注射治疗。随访2～5年评定治疗结果。结果 363例患儿治疗效果:治愈率47.9%,显效率33.6%,有效率18.5%。并发症发生率:凹陷性瘢痕3.6%,表皮纤维化8.0%,色素沉着3.3%,色素减退1.4%。结论激光联合疗法治疗婴幼儿血管瘤,可达到恢复外观和功能的最佳疗效,并可缩短治疗周期,减少并发症。

Laser Combination Therapy via Vessels Intervention

Objective To summarize the clinical therapeutic efficacy of the laser combination therapy on infantile hemangioma and to explore its optimal combination therapeutic regimen.Methods A total of 363 cases with infantile hemangioma with their complete clinical data and whole course treatment were retrospectively analyzed,including 303 cases with superficial capillary hemangioma receiving combined continuous wave Nd：YAG laser or pulsed dye laser therapy with local injection of bleomycin A5 hydrochloride,54 cases with deep hemangioma receiving combined pulsed dye laser therapy with interventional therapy,and 6 cases with severe infantile hemangioma receiving pulsed dye laser therapy with oral hormone therapy and local injection of bleomycin A5 hydrochloride.The treatment effect was evaluated after 2-5years.ResultsFor the 363 cases,the cured rate was 47.9%,the excellent rate was 33.6%,the effective rate was 18.5%,and no-effect was 0.The complication occurrence was as follows,3.6% of depressed scar,8.0% of epidermis fibrosis,3.3% of hyperpigmentation and 1.4% of hypopigmention.ConclusionsThe laser combination therapy has the most favorable therapeutic efficacy on infantial hemangioma in appearance and function recoveries,it also shortens the course of treatment and decreases the occurrence of complications.