激光光纤联合硬化注射治疗卡波西样血管内皮瘤  

Clinical efficacy of intralesional laser combined with sclerotherapy in the treatment of kaposiform hemangioendothelioma

作　　者：黄莹滢[1] 肖燕[1] 陈惠平[1] 马晓荣[1] 吕开阳 欧阳天祥[1] HUANG Yingying;XIAO Yan;CHEN Huiping;MA Xiaorong;LYU Kaiyang;OUYANG Tianxiang(Department of Plastic and Reconstructive Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院整形外科,上海200092

出　　处：《中国美容整形外科杂志》2022年第12期709-712,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨激光光纤联合硬化注射治疗卡波西样血管内皮瘤(kaposiform hemangioendothelioma,KHE)的临床效果。方法回顾性分析自2010年1月至2020年12月,上海交通大学医学院附属新华医院整形外科收治51例卡波西样血管内皮瘤患儿的临床资料,包括患儿年龄、性别、部位、疼痛症状及血小板情况[部分伴随血小板减少(Kasabach-Merritt现象,以下简称KM现象)],其中KHE伴随KM现象29例,磁共振加血管增强造影为常规诊断标准。根据不同治疗方案记为单纯微创硬化注射组(18例)及硬化注射与激光光纤联合注射组(33例)。分别记录手术操作中介入激光的能量、硬化剂药物配比、穿刺点、注射剂量、术后观察疗效及并发症。治疗评价指标为随访时评估肿块及红斑缩小范围、皮肤温度变化、疼痛缓解率、血液指标(血小板回升)。结果激光光纤联合硬化注射与单纯硬化注射治疗对KHE均有良好效果,联合组重复治疗次数较少,肿块及红斑缩小速度较快,疼痛缓解率更高,并发症较少。结论激光光纤联合硬化注射治疗KHE,单次治疗的瘤体范围更大,可迅速提升血小板;重复治疗次数较少,肿块及红斑缩小速度较快,疼痛缓解率更高,并发症更少。Objective To explore the clinical efficacy of intralesional laser combined with sclerotherapy in the treatment of kaposiform hemangioendothelioma(KHE).Methods From January 2010 to December 2020,the clinical data of 51 children with KHE were retrospectively analyzed,including age,gender,lesion location,pain symptoms and platelet status(29 cases accompanied by KasabachMerritt phenomenon).Magnetic resonance imaging and vascular enhancement were the routine diagnostic criteria.According to different treatment schemes,all children were divided into single sclerotherapy group(18 cases)and intralesional laser combined with sclerotherapy group(33 cases).The energy of intralesional laser,prescription of sclerosing agent,puncture points,injection volume,curative effect and complications after operation were recorded.The therapeutic effect indexes were as follows:the range of lumps and erythema reduction,skin temperature change,pain relief rate and blood index(platelet recovery).Results Both intralesional laser combined with sclerotherapy and single sclerotherapy had good efficacy in the treatment of KHE.The combined group had fewer repeated treatments,faster reduction of lumps and erythema,higher pain relief rate and fewer complications than single sclerotherapy group.Conclusion Intralesional laser combined with sclerotherapy for KHE has a larger treatment range than single sclerotherapy and can rapidly increase platelet count.The repeated treatment times are less,reduction of lumps and erythema is fast,pain relief rate is high and complications are few.

关 键 词：硬化注射 激光联合硬化 卡波西样血管内皮瘤 

分 类 号：R732.2[医药卫生—肿瘤]