儿童腮腺区血管瘤的治疗方法探讨  

Treatment of parotid hemangioma in children

作　　者：明澄 张铁松[1] 马静[1] 高丽[1] 娄凡[1] 林垦 曾文娟[1] 肖洋 MING Cheng;ZHANG Tiesong;MA Jing;GAO Li;LOU Fan;LIN Ken;ZENG Wenjuan;XIAO Yang(Department of Otolaryngology Head and Neck Surgery,Kunming Children's Hospital(Childrens Hospital Affiliated to Kunming Medical University),Yunnan Key Laboratory of Childrens Major Disease Research,Kunming,650228,China)

机构地区：[1]昆明市儿童医院(昆明医科大学附属儿童医院)耳鼻咽喉头颈外科云南省儿童重大疾病研究重点实验室

出　　处：《临床耳鼻咽喉头颈外科杂志》2019年第11期1076-1080,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:总结儿童腮腺区血管瘤的治疗方法及效果。方法:33例儿童腮腺区血管瘤,药物治疗22例,其中9例(27%)口服普萘洛尔,13例(40%)行B超引导下博来霉素多点注射;另11例(33%)采用手术切除血管瘤的治疗方式。结果:22例行药物治疗的患儿,治疗效果评价采用Achauer等提出的分级标准:Ⅳ级12例(54.5%);Ⅲ级7例(31.8%);Ⅱ级2例(9%);Ⅰ级1例(4.5%);其中2例(Ⅰ、Ⅱ级各1例)疗效患儿药物治疗6个月后行手术切除血管瘤。11例儿童行手术切除血管瘤,8例(73%)完整切除肿瘤,其中3例手术中残留血管瘤组织,给予残留瘤体注射博来霉素治疗。本组药物治疗显示,年龄<12个月患儿,口服普萘洛尔后,瘤体均可见不同程度地缩小,给药1周内变化最为显著,之后瘤体进一步缩小,直至治疗结束。结论:B超引导下博来霉素多点注射治疗儿童腮腺区血管瘤效果确切,不良反应发生率低,但需注射多个疗程;针对药物治疗效果不佳、复发或范围局限的患儿,可以选择手术切除血管瘤;手术应注意适应证的选择及手术操作技能,减少面神经损伤风险及术后面部遗留瘢痕。Objective: To summarize the treatment and effect of children with parotid hemangioma. Method: Thirty-three children with parotid hemangioma were treated with drug in 22 cases, 9 of which received propranolol orally, accounting for 27%;13 cases underwent B-ultrasound guided bleomycin injection, accounting for 40%;another 11 cases were used. The treatment of surgical removal of hemangioma, accounting for 33%. Result: In 22 children with drug therapy, the evaluation criteria were evaluated by Achauer et al. 12 cases of grade Ⅳ, accounting for 54.5%;7 cases of grade Ⅲ, accounting for 31.8%;2 cases of grade Ⅱ, accounting for 9%. For example, accounted for 4.5%;2 of them(1 in gradeⅠand Ⅱ) were treated with drug therapy for 6 months after surgical resection of hemangioma. Eleven children underwent surgical resection of hemangioma, and 8 patients underwent complete resection of the tumor, accounting for 73%. Among them, 3 patients had residual hemangiomas during operation, and the residual tumor was treated with bleomycin. This group of medications showed that children aged<12 months, after oral propranolol, the tumors were reduced to varying degrees, the most significant change within 1 week after administration, and then the tumor was further reduced until the end of treatment. Conclusion: B-ultrasoun lower bleomycin injection in children with parotid hemangioma is effective, and the incidence of adverse reactions is low, but multiple courses of treatment are required. For patients with poor drug treatment, recurrence or limited range, surgical resection of blood vessels can be selected. Tumor surgery should pay attention to the choice of indications and surgical operation skills, reduce the risk of facial nerve injury and postoperative facial scars. There are many different treatments for infantile hemangioma, but there is still no treatment for all children. The drug treatment of this group showed that after oral propranolol, the tumors were all reduced to varying degrees, the color became lighter, the text

关 键 词：腮腺区血管瘤 儿童 治疗方法 

分 类 号：R765[医药卫生—耳鼻咽喉科]