摘要
目的观察比较保守治疗、早期手术及晚期手术治疗卡波西样血管内皮瘤的效果。方法2004年1月至2016年12月河南省人民医院血管瘤外科收治106例卡波西样血管内皮瘤患者,男62例,女44例,年龄最小1 d,最大43岁,中位年龄94.5 d。根据治疗方式不同分为保守治疗组29例、早期手术组55例和晚期手术组22例,保守治疗组采用激素或激素联合尿素局部注射治疗;手术治疗组行手术切除瘤体,发病至手术时间<3个月为早期手术组,≥3个月为晚期手术组。疗效评定标准:治愈为瘤体消失或基本消失,血小板恢复正常,随访半年以上无复发;有效为瘤体显著缩小,血小板明显回升;无效为瘤体无缩小或继续增大,血小板无回升或继续下降。比较3组治疗后的总疗效,比较治疗前及治疗后1、7、14 d患者血小板值的变化;比较早期手术组、晚期手术组术中及术后情况。结果患者均获6~23个月随访,治愈65例,有效24例,无效12例,死亡5例。治疗7 d后3组血小板值分别为保守治疗组68(31,157)×10^9/L、早期手术组(294.75±150.59)×10^9/L、晚期手术组(221.48±148.71)×10^9/L,组间比较差异有统计学意义(P<0.05);治疗14 d后3组血小板值分别为保守治疗组78(25.5,154.5)×10^9/L、早期手术组281(234,356)×10^9/L、晚期手术组(219.67±140.95)×10^9/L,组间比较差异有统计学意义(P<0.05)。随访至少半年后3组临床疗效总有效率:保守治疗组62.07%、早期手术组96.34%、晚期手术组81.82%,两两比较差异有统计学意义(P<0.05)。早期手术组术中出血量与手术时间、术后血小板值升高时间以及总住院时间与晚期手术组比较,差异均有统计学意义(P<0.05)。结论早期手术治疗卡波西样血管内皮瘤优于晚期手术治疗和保守治疗,手术应作为治疗卡波西样血管内皮瘤首选方案,应早发现早治疗。
Objective To compare the curative effect of non-surgical treatment,early operation and advanced operation on the Kaposiform hemagioendothelioma(KHE).To explore the optimal treatment for KHE.Methods The 106 cases of KHE patients admitted by our hospital from January 2004 to December 2016 were selected as the study subjects.The age is the minimum 1d and the maximum 43 years,median age 94.5 d.According to different treatment methods,they were divided into non-surgical treatment and surgical treatment:according to the onset of the disease and the day of the operation,the early operation was performed less than three months since the onset of the disease,and the advanced operation more than 3 months.Efficacy evaluation criteria:The recovery meant that the tumor disappeared or mostly disappeared,the platelets returned to normal,and there was no recurrence more than half a year after treatment."Effective"indicated that tumors were shrunken significantly and the platelet counting rose significantly."Ineffective"indicated that the tumor was not shrunken or continued to increase and platelet counting did not rise or continued to decrease.The three groups of patients were followed up,and the efficacy of the three groups after treatment and the changes of platelet counting before and after treatment on day 1,7 and 14 were compared.The two groups of early and late treatment were compared for operative and postoperative conditions.Results All patients were followed up for 6-23 months,24 cases were effective,12 cases were ineffective,and 5 cases died.After 7 days of treatment,the platelet counting of the three groups were 68(31,157)×10^9/L in the non-surgical treatment group,(294.75±150.59)×10^9/L in the early operation group,(221.48±148.71)×10^9/L in the late operation group,with statistical significance(P<0.05).After 14 days of treatment,the platelet counting of the three groups were 78(25.51,54.5)in the non-surgical treatment group,281(234,356)×10^9/L in the early operation group,and in the late operation group(219.67±140.95)×10^9/L,with statistical significance(P<0.05).After at least half a year of follow-up,the total effective rate of clinical efficacy in the three groups was the non-surgical treatment group 62.07%,the early operation group 96.34%and the late operation group 81.82%;the difference was statistically significant between two groups(P<0.05);There was significant difference between the early operation group and the late operation group in the amount of bleeding and operation time,the time of platelet counting and the total hospitalization time(P<0.05).Conclusions Early surgical treatment of Kaposiform hemangioendothelioma is superior to late-operative and non-surgical treatment.Surgical treatment will be the preferred option for treatment of Kaposiform hemangioendothelioma,and examinations should be operated to potential patients for early diagnosis.
作者
稂翠玲
龚毓宾
董长宪
周粤闽
Lang Cuiling;Gong Yubin;Dong Changxian;Zhou Yuemin(Huaihe Hospital of Henan University,International Joint Research Laboratory for Cell Medical Engineering of Henan,Kaifeng 475000,China;Department of Hemangioma,Henan People′s Hospital,Zhengzhou 450003,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第1期29-34,共6页
Chinese Journal of Plastic Surgery
关键词
卡波西样血管内皮瘤
临床分析
治疗方案
Kaposiform hemangioendothelioma
Clinical analysis
Treatment regimen
