婴幼儿血管瘤治疗理念与方法的转变

doi:10.3877/cma.j.issn.1674-1366.2015.02.001

中华口腔医学研究杂志(电子版) ›› 2015, Vol. 09 ›› Issue (02) : 91 -94. doi: 10.3877/cma.j.issn.1674-1366.2015.02.001

所属专题：口腔医学；文献；

专家笔谈

婴幼儿血管瘤治疗理念与方法的转变

郑家伟¹^,^†(

), 张凌¹

^1. 200011　上海交通大学医学院附属第九人民医院·口腔医学院　口腔颌面-头颈肿瘤科

收稿日期:2015-03-10 出版日期:2015-04-01
通信作者: 郑家伟
基金资助:
国家自然科学基金(81271163、81470755)

Shift of treatment algorithm and methods for infantile hemangiomas

Jiawei Zheng¹^,^†(), Ling Zhang¹

^1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People′s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2015-03-10 Published:2015-04-01
Corresponding author: Jiawei Zheng
About author:
Corresponding author: Zheng Jiawei, Email: zhjw@omschina.org.cn

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婴幼儿血管瘤（IH）是儿童最常见的良性血管肿瘤。近年来，随着医疗技术的进步和对IH病因与发病机制的深入了解，IH的治疗理念与方法已经发生了很大转变，主要表现在变"等待观察"为积极干预，强调循序渐进和个体化治疗；药物治疗首选普萘洛尔，激光治疗仅限于处理表浅血管瘤、溃疡病灶和消退期遗留的毛细血管扩张；手术主要用于切除消退期或治疗后残存的病变，如瘢痕、皮肤凹陷、臃余皮肤、纤维脂肪残留物等。

关键词: 婴幼儿血管瘤, 普萘洛尔, 噻吗洛尔, 脉冲染料激光

Infantile hemangiomas (IHs) are the most common benign vascular tumors in infancy, occurring in 10% of full term babies and up to 25% of premature babies. In recent years, with the progress of medical technology and in depth understanding of the etiology and pathogenesis of IHs, the treatment algorithm and methods for infantile hemangiomas have been greatly changed. There is a general agreement that IHs should be treated in the early phase rather than wait and see. The treatment should be gradually advanced from non-or minimally invasive to invasive and meanwhile individualized. Oral propranolol has become the first-line treatment choice of IHs. Laser therapy is limited to treat superficial hemangiomas, ulcerated hemangiomas and residual skin telangiectasias. Surgery is mainly used to correct residual lesions after self-involution or various treatments, including residual scarring, permanent disfigurement, redundant or loose skin, and fibro-fatty residuum.

Key words: Infantile hemangioma, Propranolol, Timolol, Pulsed dye laser

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