先天性声门下血管瘤的管理：过去17年的趋势与成效
Management of congenital subglottic hemangioma: trends and success over the past 17 years.
作者信息
Bitar Mohamed A, Moukarbel Roger V, Zalzal George H
机构信息
Department of Otolaryngology-Head and Neck Surgery, American Univeristy of Beirut Medical Center, American University of Beirut School of Medicine, Lebanon.
出版信息
Otolaryngol Head Neck Surg. 2005 Feb;132(2):226-31. doi: 10.1016/j.otohns.2004.09.136.
OBJECTIVE
To evaluate the success and complications of various treatment options of congenital subglottic hemangioma.
STUDY DESIGN AND SETTINGS
Reported cases were grouped by treatment modalities and corresponding outcome evaluated.
RESULTS
From 1986 through 2002, 372 patients were reported in 28 series. Carbon dioxide laser had 88.9% success rate yet 5.5 % significant subglottic stenosis. It shortened the tracheotomy duration by 13.7 months. Corticosteroids were not that beneficial (useful in only 24.5%) with 12.9% side effects. Intralesional corticosteroids were successful in 86.4% with 5.6% complication rate. Surgical excision (as young as 2.5 months), was useful in 98% with 10% complication rate, using cartilage grafts in 34%. Other modalities were less popular.
CONCLUSION
Treatment should be individualized. Guidelines are suggested. Priority is given to secure the airways. The CO 2 laser is useful when used cautiously. Steroids may be beneficial. Excision is for stubborn cases.
目的
评估先天性声门下血管瘤各种治疗方法的成功率及并发症。
研究设计与环境
将报告的病例按治疗方式分组，并对相应结果进行评估。
结果
1986年至2002年，28个系列共报告了372例患者。二氧化碳激光治疗成功率为88.9%，但有5.5%出现严重声门下狭窄。它使气管切开持续时间缩短了13.7个月。皮质类固醇效果不佳（仅24.5%有效），且有副作用（12.9%）。瘤内注射皮质类固醇成功率为86.4%，并发症发生率为5.6%。手术切除（小至2.5个月），98%有效，并发症发生率为10%，34%使用软骨移植。其他治疗方式不太常用。
结论
治疗应个体化。提出了指导原则。首要任务是确保气道通畅。谨慎使用二氧化碳激光是有效的。类固醇可能有益。手术切除适用于顽固病例。
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