摘要
目的:探讨不同类型淋巴管瘤的治疗方法及其可行性与优越性。方法:选择7例行淋巴管瘤治疗的新生儿,包括产时介入治疗(平阳霉素局部注射)1例,产时手术(子宫外产时处理-EXIT联合产房外科手术)3例,生后第2天行介入治疗3例,对各种治疗方法的适应证及临床效果进行分析并对新生儿的预后进行随访,进一步评价各种治疗方法的可行性与优越性。结果:产时介入治疗1例患儿瘤体局部注射药物后未出现相关并发症,术后3天与其母同时出院,肿瘤明显缩小;术后1个月返院复查,肿瘤局部仅留小结节,未给予再次注射药物;术后半年～1年返院复查肿瘤无复发,生长发育正常。产时手术3例,术后恢复良好,随访2～3年,患儿生长发育正常,其中2例术后1年内瘢痕较明显,术后2年后切口愈合良好,瘢痕几乎看不出。生后第2天行介入治疗3例,术后按期出院,未出现相关并发症,术后半年～1年返院复查,肿瘤无复发,生长发育正常。结论:对于瘤体大、压迫气管会造成新生儿窒息的淋巴管瘤可选择产时手术治疗;对于包绕重要血管神经的囊性淋巴管瘤,介入治疗为其首选治疗方法;产时介入治疗新生儿淋巴管瘤是可行的,最好在手术室有一定条件能完善急检血常规及胸片的前提下完成,以避免相关并发症的发生。对于综合治疗及宫内介入治疗仍需进一步研究。
Objective： To explore the therapeutic methods of different types of lymphangioma and the feasibilities and superiorities. Methods： Seven neonates With lymphangioma were selected and treated, the therapeutic methods included intrapartum interventional therapy （one neonate treated with local injection of bleomyein）, intrapartum surgery （three neonates treated with extrauterine intrapartum treatment - EXIT combined with surgery in delivery room）, and interventional therapy on the second day after birth （3 neonates） ; the indications and clinical effects of different therapeutic methods were analyzed, the prognosis of neonates was followed up, the feasibilities and superiorities of different therapeutic methods were further evaluated. Results： One neonate was treated with local injection, no related complication oc- curred, then the neonate and his/her mother left the hospital at three days after surgery, the size of lymphangioma decreased significantly, reexamination was conducted at one month after surgery, there was only a small nodule, so the neonate didnt receive local injection again; the neonate was reexamined during half a year -one year after surgery, recurrence didnt occur, the growth and development of the neonate was normal. Three neonates were treated with intrapartum surgery, the postoperative recovery was good, the three neonates were followed up for 2 - 3 years, the growth and development was normal, the scars of two neonates within one year after surgery was obvious, but the healing of incision at two years after surgery was good, and the scares could be seen hardly. Three neonates received interventional therapy on the second day after birth, then they left the hospital on time, no related complication occurred, all the three neonates were reexamined during half a year - one year after surgery, recurrence didnt occur, the growth and development of the three neonates was normal. Conclusion ： For the neonates with asphyxia induced by oppressing trachea because of large lymphangioma, intrapartum surgery can be conducted; for the neo- nates with cystic lymphangioma surrounding important vessels and nerves, interventional therapy is the first choice ; intrapartum interventional therapy is feasible for treatment of neonatal lymphangioma, and it is best to be completed in a operating room with a certain condition to con- duct perfect urgent blood routine examination and chest radiography to avoid related complications. Comprehensive treatment and intrauterine interventional therapy still need further studies.
出处
《中国妇幼保健》
CAS
北大核心
2013年第6期944-946,共3页
Maternal and Child Health Care of China
基金
辽宁省科学技术计划项目〔2010225034〕
关键词
淋巴管瘤
介入治疗
平阳霉素
产时手术
Lymphangioma
Interventional therapy
Bleomycin
Intrapartum surgery
