中国实用口腔科杂志

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血管瘤的治疗选择

郑家伟杨秀娟   

  1. 上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科
  • 收稿日期:2009-04-10 修回日期:1900-01-01 出版日期:2009-05-15 发布日期:2009-05-15

  • Received:2009-04-10 Revised:1900-01-01 Online:2009-05-15 Published:2009-05-15

摘要: 血管瘤是婴幼儿最常见的先天性良性血管肿瘤,约60%发生于头颈部。通常在1岁以内快速增殖,大多数血管瘤可自行消退。血管瘤的治疗方法多种多样,但迄今尚无一种方法适用于所有类型血管瘤的治疗。根据血管瘤部位、大小、范围、深度、分期、功能影响以及对患儿的心理影响等因素的不同,其治疗方法的选择也不相同。较小的、处于稳定期或消退期的血管瘤可以等待观察;浅表血管瘤可采用咪喹莫特软膏局涂、激光或激光+激素治疗;深部血管瘤可采用激素、平阳霉素瘤内注射治疗;多发性血管瘤、重症血管瘤或生长迅速的血管瘤首选口服激素或普萘洛尔治疗,治疗无效时可采用干扰素皮下注射治疗;手术治疗一般不作为早期血管瘤的首选治疗方案。增殖期血管瘤需按照循序渐进的原则进行治疗,避免过度治疗。

关键词: 血管瘤, 激素, 激光治疗, 干扰素

Abstract: Hemangiomas are the most common benign vascular tumors of infancy and childhood,60% of which involve the head and neck region. It is characterized by a rapid proliferating phase followed by spontaneous involution. Various therapeutic approaches to infant hemangiomas have been described, but the optimal management for all hemangiomas has not yet been completely defined. In recent years, a lot of methods have been proposed and applied, including wait and see policy, laser therapy, drug therapy (corticosteroid, imoquimod, propranolol), sclerotherapy (corticosteroid, Pingyangmycin), radiotherapy, surgery and so on. The type of treatment advised for hemangioma mainly depends on the location, depth, size, current phase and functional impairment of lesions. In some cases, the psychology of patients and amount of parental concern should also be considered. Topical application of imiquimoid and laser therapy can be used in patients with small and superficial hemangiomas. Systematic drug therapy (steroids, interferonα-2a, propranolol ) should be considered for large hemangiomas, multiple hemangiomas and hemangiomas with severe complications. The patients’ condition and treatment planning must be carefully evaluated to prevent overtreatment or mistreatment.

Key words: hemangioma, hormone, laser therapy, interferon