介入栓塞与局部注射治疗卡波西型血管内皮瘤合并卡梅现象的效果  

Effect of Interventional Embolization Combined with Topical Injection in the Treatment of Kaposiform Hemangioendothelioma Complicated with Kasabach-Merritt Phenomenon

作　　者：赵磊[1] 丁语[1] 徐伟洋 皮梦奇 徐淼 ZHAO Lei;DING Yu;XU Weiyang;PI Mengqi;XU Miao(Involvement Hemangioma and Vascular Surgery,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院介入血管瘤和血管外科,河南郑州450000

出　　处：《河南医学研究》2022年第23期4230-4234,共5页Henan Medical Research

基　　金：2022年河南省医学科技攻关联合共建项目(LHGJ20220739)。

摘　　要：目的探讨介入栓塞与局部注射治疗卡波西型血管内皮瘤(KHE)合并卡梅现象(KMP)的效果。方法回顾性分析郑州大学附属儿童医院2020年1月至2021年10月收治的10例KHE合并KMP的患儿,选择平阳霉素碘化油乳剂和/或聚乙烯醇颗粒对瘤体进行介入栓塞,残余病灶行平阳霉素稀释液局部注射,观察治疗前后的血小板变化及远期效果。结果7例术后即刻血小板升高,10例术后24 h血小板均明显升高,10例术后72 h血小板>100×10^(9) L^(-1)。术前血小板(29.7±13.8)×10^(9) L^(-1),术后72 h血小板(184.5±39.6)×10^(9) L^(-1),差异有统计学意义(t=11.687,P<0.05)。术后随访6个月~2 a,7例达到治愈,3例达到好转。结论介入栓塞与局部注射治疗KHE合并KMP安全有效,能够较快纠正血小板减少,远期基本可以达到外观满意、功能良好的疗效。Objective To explore the effect of interventional embolization combined with topical injection in the treatment of kaposiform hemangioendothelioma(KHE)complicated with Kasabach-Merritt phenomenon(KMP).Methods From January 2020 and October 2021,10 cases of KHE complicated with KMP in Children’s Hospital Affiliated to Zhengzhou University were retrospectively analyzed.They were treated with interventional embolization using pingyangmycin iodized oil emulsion and/or polyvinyl alcohol particles and topical injection with pingyangmycin diluents.The changes of platelet before and after treatment and the long-term effect were observed.Results The platelet counts of 7 patients were elevated immediately after operation.The platelet counts of 10 patients were elevated obviously at 24 hours after operation,10 patients had platelet counts greater than 100×10^(9) L^(-1) at 72 hours after operation.The platelet count was(29.7±13.8)×10^(9) L^(-1) before operation and(184.5±39.6)×10^(9) L^(-1) at 72 hours after operation,and the difference was significant(t=11.687,P<0.05).All patients were followde up from 6 months to 2 years,7 cases were cured and 3 cases were improved.Conclusion The therapy of interventional embolization combined with topical injection is safe and effective in the treatment of KHE complicated with KMP,which can quickly increased platelet count.Good clinical results can be achieved with satisfactory appearance and function in the long-term.

关 键 词：血管内皮瘤 卡梅现象 介入栓塞 局部注射 平阳霉素 

分 类 号：R732.2[医药卫生—肿瘤]