体表巨大血管瘤的外科治疗

目的探讨治疗体表巨大血管瘤的有效方法。方法我院1995-02～2003-12手术治疗体表巨大血管畸形56例,其中12例蔓状血管瘤患者行术前选择性动脉栓塞;20例弥漫型海绵状血管瘤患者术中联合Nd押YAG激光照射;24例行单纯手术切除。结果术后随访3个月至8年,手术治愈率92.9%。其中行术前动脉栓塞和术中激光照射的32例均治愈;单纯手术切除治愈20例,手术失败1例,术后复发3例。结论沿着病灶周围“安全平面”进行手术是保证巨大血管畸形根治性切除的前提。根据不同类型血管畸形,选择手术联合术前供瘤动脉栓塞或术中Nd:YAG激光照射的综合治疗方法,对提高手术切除率至关重要。

Surgical treatment of giant hemangioma on body surface

Objective To investigate the effective surgical therapy of giant hemangioma(vascular malformation)on body surface.Methods The 56 cases of giant hemangiomas underwent surgical treatment from February 1995 to December 2003.Among them 12 cases with arteriovenous malformations(plexiform hemangiomas) underwent selective embolization of the feeding arteries before operation, 20 cases with extensive venous malformations(cavernous hemangiomas) received Nd:YAG laser irradiation during operation and the other 24 cases were operated on only.Results Followed up from 3 months to 8 years,all the patients had good restoration of contour and function with a total operative cure rate of 92.9 percent,except 1 case of operative failure and 3 cases of postoperative recurrence among the cases received single surgery.Conclusions Radical resection for giant hemangioma is fundamentally determined by complete dissection over the so-called"safety level" around the lesion. Surgical resection combined with preoperative transarterial embolization of the feeding arteries or Nd:YAG laser irradiation during operation according to different type of hemangioma is the key to surgical effectiveness.