肢体血管瘤伴Kasabach—Merritt现象的外科处理  

Surgical treatment of hemangioma of limbs associated with Kasabach-Merritt phenomenon

作　　者：刘大看[1] 马玉春[1] 郭晓楠[1] 朱晓爽[1] 董长宪[1] 

机构地区：[1]郑州大学人民医院(河南省人民医院)血管瘤外科,450003

出　　处：《中华皮肤科杂志》2013年第11期822-823,共2页Chinese Journal of Dermatology

基　　金：河南省医学科技攻关计划省部共建项目（2011010010）

摘　　要：目的探讨小儿肢体血管瘤并发Kasabach—Merritt现象的外科处理方法。方法回顾性分析并发Kasabach—Merritt现象的sbJL肢体部血管瘤病例31例，下肢19例，上肢12例。血小板计数（2．6～60）×10^9／L合并纤维蛋白原〈1g/L者26例，部分凝血酶原时间〉50s者21例。所有病例经糖皮质激素及药物治疗效果不佳，接受外科处理。结果治愈30例，死亡1例；术后1—3d血小板计数恢复正常25例，3～7d恢复正常4例，〉10d恢复正常1例。结论对合并Kasabach—Merritt现象的小儿肢体血管瘤，应尽早进行外科处理，从而降低患儿死亡率。Objective To analyze the surgical treatment of hemangioma of limbs complicated by Kasabach- Merritt phenomenon in children. Methods A retrospective study was carried out on 31 children with hemangioma of limbs complicated by Kasabach-Merritt phenomenon. Lower limbs were affected in 19 patients, and upper limbs in 12 patients. Twenty-six patients showed decreased platelet count （（2.6 - 60） × 10^9/L） and fibrinogen level （〈 1 g/L）, and 21 prolonged partial prothrombin time （〉 50 seconds）. All the patients who had responded poorly to medications including glucocorticoids received surgical treatment. Results Of these patients, 30 were cured, and one died of massive blood loss. After surgical treatment, the platelet count returned to normal in 1 - 3 days in 25 patients, 3 - 7 days in 4 patients, and more than 10 days in one patient. Conclusions For pediatric hemangiomas of limbs complicated by Kasabach-Merritt phenomenon, surgical treatment should be given as early as possible so as to reduce mortality in patients.

关 键 词：外科处理方法 肢体血管瘤 部分凝血酶原时间 血小板计数 纤维蛋白原 糖皮质激素 治疗效果 死亡率 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]