Hintringer T
Klinische Abteilung für Plastische, Asthetische und Rekonstruktive Chirurgie, Krankenhaus der Barmherzigen Schwestern, Linz, Osterreich.
Handchir Mikrochir Plast Chir. 2009 Apr;41(2):83-7. doi: 10.1055/s-2008-1038775. Epub 2008 Nov 14.
Haemangiomas represent the most common type of benign vascular tumours in childhood. A proliferative phase of unknown duration and extent is followed by an involutional period, which passes into regression in approximately 70 % of all cases. A multitude of different treatment options, such as corticosteroids, cryotherapy, laser, sclerotherapy, radiotherapy and surgical methods have been published. Due to the high rate of spontaneous regression, many authors advise not to undertake any treatment. The dilemma of this "wait and see" approach constitutes those cases in which sudden and pronounced growth is not followed by complete regression with possible severe aesthetic and functional impairment. To avoid this dilemma, a specific algorithm for the treatment of haemangiomas was instituted at our department, based essentially on early laser treatment when relevant growth is present.
More than 2000 patients with haemangiomas as well as vascular malformations have been treated at our department in the last 16 years. An algorithm for treatment of these disorders is presented.
All therapeutic procedures, especially direct neodymium-YAG laser treatment with either contact cooling or intralesional, is described and postinterventional results are presented.
Early laser treatment of fast growing haemangiomas prevents uncontrolled proliferation of these childhood tumours and, in our experience, represents a definite improvement of long-term results when compared to the "wait and see" method.
血管瘤是儿童期最常见的良性血管肿瘤类型。在经历一段持续时间和范围不明的增殖期后，进入消退期，约70%的病例会完全消退。目前已发表了多种不同的治疗方法，如皮质类固醇、冷冻疗法、激光、硬化疗法、放射疗法和手术方法等。由于自发消退率较高，许多作者建议不进行任何治疗。这种“观察等待”方法的困境在于，有些病例在突然显著生长后并未完全消退，可能会造成严重的美学和功能损害。为避免这种困境，我们科室制定了一种特定的血管瘤治疗方案，主要基于在出现相关生长时尽早进行激光治疗。
在过去16年里，我们科室治疗了2000多名患有血管瘤及血管畸形的患者。本文介绍了针对这些病症的治疗方案。
描述了所有治疗程序，特别是采用接触式冷却或瘤内注射的直接钕钇铝石榴石激光治疗，并展示了介入后的结果。
对快速生长的血管瘤进行早期激光治疗可防止这些儿童肿瘤的无节制增殖，根据我们的经验，与“观察等待”方法相比，这确实改善了长期治疗效果。
