【作者】 秦中平； 李克雷； 胡秀启； 刘学键；

【Author】 QIN Zhong-ping, LI Ke-lei, HU Xiu-qi, LIU Xue-jian. (Department of Hemangioma and Vascular Malformations, Tumor Hospital of Linyi City. Linyi 276001, Shandong province, China)

【机构】 山东省临沂市肿瘤医院省A级血管瘤特色专科；

【摘要】 目的:研究探讨血管瘤和血管畸形的临床鉴别要点。方法:选择1997年3月～1999年2月间在本院初诊,未做任何治疗的8个月以内的婴幼儿血管瘤患者86例,其中毛细血管瘤41例,海绵状血管瘤15例,混合型血管瘤30例。86例中46例接受糖皮质激素治疗,40例说服家长,随访观察。结果:全组病例随访5～7a。41例毛细血管瘤和7例海绵状血管瘤及20例混合型血管瘤表现出不同程度的消退;8例海绵状血管瘤,皮肤表面显示浅静脉扩张显露,加压瘤体明显缩小,病变持续长大,不消退;10例混合型血管瘤,皮肤温度明显增高,瘤体周围静脉扩张,加压瘤体明显缩小,去除压力后充盈,深部瘤体逐渐长大,不消退。结论:婴幼儿血管瘤中的毛细血管瘤均在2岁以内开始消退,但部分海绵状和混合型血管瘤病变持续长大,不消退。瘤体表面皮肤温度、加压瘤体是否明显缩小、瘤体表面及周围皮肤是否有扩张显露的浅静脉、瘤区能否扪及动脉搏动,以及瘤体造影是否有增粗的回流静脉等指标,是临床区别血管瘤和血管畸形的可靠依据。更多还原

【Abstract】 OBJECTIVE: To explore the main points of clinical differentiation between hemangioma and vascular malformation of infant. METHODS: From March 1997 to February 1999, 86 infantile patients with hemangioma were treated. They were fewer than 8 months and hadn’t received any treatment before. The types of hemangiomas included capillary (41), cavernous (15) and mixed (30). 46 cases received medical treatment of steroids, 40 cases were persuaded to wait and see. RESULTS: All the patients were followed up from 5 to 7 years. There was involution to varying degrees in 41 capillary tumors , 7 cavernous tumors and 19 mixed hemangiomas . There were obvious shallow veins dilatation on the surface of 8 cavernous hemangiomas. The tumors shrank obviously when pressuring it. The tumors grew gradually and didn’t involute .The skin temperature of 11 mixed hemangiomas rose obviously. There was vein dilatation in circumference of the tumor. The tumors shrank obviously when pressuring. The tumors plumped up rapidly after removing the pressure. The deep part of the tumors grow gradually and didn’t disappear. CONCLUSION: All the capillary tumors begin to involute when infants are about one year old, but cavernous tumors and mixed tumors grew gradually and didn’t disappear in some cases. Whether the skin temperature of tumor surface rose or not, whether the pressure of tumors reduced obviously or not; whether there are obvious dilative veins on the tumors or not; whether the surface of tumors have artery pulsation, or not; whether there are obvious draining veins in the intratumorous angiography or not. All the indexes are very important basis to differentiate hemangioma from vascular malformation in clinical diagnosis.更多还原