唇部婴幼儿血管瘤溃疡后继发唇裂的临床特征及治疗策略  

Clinical Features and Treatment Strategies of Secondary Cleft Lip Resulting from Ulcerated Hemangiomas

作　　者：高阳[1] 胡晓洁[1] 林晓曦[1] 陈辉[1] 金云波[1] 马刚[1] 仇雅璟[1] 杨希[1] 李伟[1] 王翔[2] 

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011 [2]新疆医科大学第五附属医院放化疗科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《组织工程与重建外科杂志》2016年第2期124-127,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨唇部婴幼儿血管瘤溃疡后导致继发唇裂的发病原因、临床特征和治疗策略。方法对我科2012年12月至2014年1月收治的全部IH患儿中出现的溃疡导致继发性唇裂的发病情况、临床特征、治疗及预后进行回顾性统计分析。结果共计528例患儿诊断为IH,其中33例患儿为唇部IH,共3例患儿发生溃疡。全部3例溃疡患儿在溃疡发生后1周内即接受口服普萘洛尔治疗(2 mg/Kg·d),但未能阻止溃疡进一步恶化。2例患儿在溃疡后出现继发性唇裂。在血管瘤增生停止后,全部2例患儿即接受早期手术修复治疗,并取得了满意效果。结论普萘洛尔不能完全阻止唇部区域IH溃疡的发生及进展,溃疡不断进展可导致继发性唇裂等严重继发性损害。在IH增生期停止后进行早期的缺损修复手术,不但能够取得良好的治疗效果,且相较于IH完全消退后的治疗,更有利于降低患儿生理痛苦和减少对心理健康的影响。Objective To explore the etiology, clinical features and treatment strategies of secondary cleft lip resulting from ulcerated hemangiomas. Methods A retrospective analysis of IH from Dec 2012 to Jan 2014 was performed. The etiology, clinical features and treatment strategies of secondary cleft lip resulting from ulcerated hemangiomas were analyzed.Results The medical records of 528 IH were examined. 33 IH（20 girls and 13 boys） located in lip area. Only 3 developed ulceration, and 2 of 3 resulted in secondary complete cleft lip, both girls. Propranolol was used at 2 mg/kg/d to treat the IH just one week after ulceration, the cleft lip inevitably happened after medicine therapy. Both patients received surgical repair of cleft lip and obtained good results. Conclusion Cleft lip is a rare complication of ulcerated hemangioma. Propranolol can not prevent cleft lip after the ulceration of IH absolutely. An early stage repair surgery at the beginning of involuting phase is more helpful in reducing pain and uncomfortable of both physical and psychological than the repair after an absolute involution.

关 键 词：婴幼儿血管瘤 溃疡 唇裂 普萘洛尔 

分 类 号：R732.2[医药卫生—肿瘤]