彩色多普勒超声对婴幼儿血管瘤治疗方式选择的临床评价

李敏; 刘娟; 骆丹; 周炳荣

doi:10.24920/J1001-9294.2017.013

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彩色多普勒超声对婴幼儿血管瘤治疗方式选择的临床评价

中国医学科学杂志（英文版） 2017年32卷第2期页码：100-106

Orginal Article | Updated：2024-04-10

- 彩色多普勒超声对婴幼儿血管瘤治疗方式选择的临床评价
- Affiliations：
  
  1. 1Department of Dermatology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, China
  2. 2Department of Dermatology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Author bio：
  
  *Corresponding author Tel: 86-25-83714511, E-mail address: daniluo2013@njmu.edu.cn (Dan Luo); Tel: 86-25-83714511, E-mail: bingrong.2002@163.com(Bingrong Zhou). †These authors contributed equally to this article.
- Funds：
  
  △Supported by grants of the National Natural Science of China (No.81000700.No. 81573072).
- DOI：10.24920/J1001-9294.2017.013
  中图分类号：
- 收稿日期：2016-04-29，
  
  网络出版日期：2017-06-20，
  
  纸质出版日期：2017-06
- Accepted：
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李敏, 刘娟, 骆丹, 等. 彩色多普勒超声对婴幼儿血管瘤治疗方式选择的临床评价[J]. 中国医学科学杂志（英文版）, 2017,32(2):100-106.

Li Min, Liu Juan, Maya Valeska, et al. Clinical Evaluation of Color Doppler Ultrasound in Selecting the Optimal Treatment Modality for Infantile Hemangioma^△[J]. Chinese medical sciences journal, 2017, 32(2): 100-106.
李敏, 刘娟, 骆丹, 等. 彩色多普勒超声对婴幼儿血管瘤治疗方式选择的临床评价[J]. 中国医学科学杂志（英文版）, 2017,32(2):100-106. DOI： 10.24920/J1001-9294.2017.013.

Li Min, Liu Juan, Maya Valeska, et al. Clinical Evaluation of Color Doppler Ultrasound in Selecting the Optimal Treatment Modality for Infantile Hemangioma^△[J]. Chinese medical sciences journal, 2017, 32(2): 100-106. DOI： 10.24920/J1001-9294.2017.013.

摘要

目的

比较彩色多普勒超声引导下选择1064nmNd:YAG激光、强脉冲光（intense pulsed light

IPL）和聚桂醇注射的不同治疗方法与单纯采用激光治疗婴儿血管瘤的疗效与安全性。

方法

将临床确诊为婴儿血管瘤的患者随机分为A组（治疗前进行彩色多普勒超声检查）和B组（无超声检查的经验性治疗）。A组根据超声显示的病变深度分为4个亚组：A-1组：强脉冲光治疗（深度

1.2 mm）;A-2组：长脉宽1064 nmNd:YAG激光治疗（1.2mm≤深度

3.0 mm）;A-3组：长脉宽1064 nmNd:YAG激光和强脉冲光联合治疗（3.0mm≤深度

5.0 mm）;A-4组：聚桂醇注射治疗（深度≥ 5.0 mm）。B组全部采用长脉宽1064 nmNd:YAG激光治疗。随访三月

根据病变治疗前后的变化评估治疗的疗效

并记录两组病患所发生的不良反应

对两组治愈率、有效率及不良反应率进行统计学比较。

结果

共收集113例患儿

128处皮损。A组85例患儿的平均年龄（6.8±7.9）月

B组28例患者的平均年龄（6.9±9.9）月。A组血管瘤的深度范围0.5~7.8 mm

平均3.27±1.07 mm

A-1、A-2、A-3和A-4各亚组的平均深度分别为0.8±0.37 mm、2.2±0.44 mm、4.2±0.64 mm和6.2±0.73 mm。A组治愈率(64.5% vs 56.3%

U=3.378

P=0.045)和有效率（89.5% vs 78.1%

U=4.163

P=0.041)显著高于B组。A组不良反应发生率（水疱20.0%

色素沉着46.9%

瘢痕形成17.7%）低于B组（水疱21.9%

色素沉着60.4%

瘢痕形成25.0%）

其中色素沉着和瘢痕发生率两组差异有统计学意义(U=3.884

P=0.034; U=4.016

P=0.032)。

结论

彩色多普勒超声引导下选择长脉宽1064 nmNd：YAG激光、强脉冲光、或聚桂醇注射等治疗方法

对婴儿血管瘤的治疗效果和安全性优于未经超声检查单纯采用激光治疗

提示彩色多普勒超声有助于婴儿血管瘤治疗方式的优选。

Abstract

Objective

We investigated the efficacy and safety of 1064 nm Nd: YAG laser

intense pulsed light (IPL)

and lauromacrogol injection in the treatment of hemangioma

in order to evaluate the value of color Doppler ultrasound guidance in choosing the optimal treatment modality.

Methods

Infantile patients who were clinical diagnosed as hemangiomas were randomly divided into group A

who had color Doppler ultrasound examinations before the treatment

and group B who had the treatment without ultrasound evaluation. Patients in the group A were assigned into subgroups according to the depth of lesion by sonography: group A-1 for those who had a lesion depth

1.2 mm

and took intense pulsed light therapy; group A-2 for those who had a lesion depth ≥1.2mm and

3 mm

and took long pulse 1064 nm Nd:YAG laser therapy; group A-3 for those who had a lesion depth ≥3mm and

5 mm

and were treated by IPL combined with long pulse 1064 nm Nd:YAG laser treatment; Group A-4 for those who had a lesion depth ≥5 mm

and took lauromacrogol injection therapy. Patients in the group B took long pulse 1064 nm Nd:YAG laser treatment without preoperative ultrasound evaluation. The efficacy and adverse reactions of the treatments between the groups were evaluated and compared statistically.

Results

Totally 113 patients with 128 skin lesions were enrolled in this study

85 in the group A (mean age 6.8±7.9 months) and 28 in the group B (mean age 6.9±9.9 months). The mean depth of hemangioma was 3.3±1.1 mm in the group A

ranging from 0.5-7.8 mm

with 0.8±0.4 mm

2.2±0.4 mm

4.2±0.6 mm and 6.2±0.7 mm in group A1

A3 and A4

respectively. The cure rates and effective rates in the group A were significantly higher than those in the group B (cure rates: 64.5%

56.3%

=3.378

=0.045; effective rates: 89.5%

78.1%

=4.163

=0.041). The adverse effect rates of the group A (vesicle 20.0%

pigmentation 46.9%

scarring 17.7%) were lower than those of the group B (vesicle 21.9%

pigmentation 60.4%

scarring 25.0%). Incidences of pigmentation and scarring were statistically significantly different (

=3.884

=0.034

and

=4.016

=0.032 respectively) between the two groups.

Conclusion

With the guidance of color Doppler ultrasound

the efficacy and safety of long pulse 1064 nmNd:YAG laser

intense pulsed light

and lauromacrogol injection in the treatment of infantile hemangioma have better outcomes compared to laser treatment alone without preoperative ultrasound examination.

关键词

Keywords

references

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