Department of Surgery, College of Physicians & Surgeons, Columbia University, 630W 168th St., New York, NY 10032, USA.
Department of Dermatology and Pediatrics, College of Physicians & Surgeons, Columbia University, 630W 168th St., New York, NY 10032, USA.
J Plast Reconstr Aesthet Surg. 2014 Sep;67(9):1215-21. doi: 10.1016/j.bjps.2014.05.007. Epub 2014 May 16.
Infantile hemangiomas (IHs) spontaneously involute, but some leave contour deformities necessitating surgical correction. There is a paucity of data reviewing predictive risk factors associated with a need for surgery to guide clinicians when counseling parents. Patients undergoing IH resection by a single surgeon from August 2004 to August 2011 were reviewed to determine patient (age, gender, birth history) and IH characteristics (size, location) associated with surgical intervention. Data were compared to published data from the Hemangioma Investigator Group (HIG). Statistical analysis was performed using Student's t-test, odds ratio, and logistic regression analysis. Out of 196 referred patients, 112 underwent surgery. There was a female preponderance (3.5:1). Two-thirds of patients (64.9%) first presented to the surgeon at ≤2 years of age, but most underwent surgery between 2 and 3 years (52.7%; average lag time, 11 months). 18 patients underwent surgery at ≤1 year of age. IH patients with preterm birth history had increased risk for needing surgical intervention (odds ratio 2.124, CI 1.31-3.44; p < 0.0012). A majority (84.7%) of resected IHs were located on the head or neck, significantly higher than the distribution from the HIG data (62.2%; p < 0.0001). Resected head and neck IHs were smaller than those below the neck (average, 8.85 cm(2) vs. 22.35 cm(2), p = 0.017). Preterm birth is associated with higher risk for requiring surgical intervention. IHs on the head and neck are more likely to be removed when compared to those below the neck, and at a smaller size threshold.
婴儿血管瘤（IHs）会自发消退，但有些会留下轮廓畸形，需要手术矫正。目前缺乏数据来回顾与手术相关的预测风险因素，以指导临床医生在为家长提供咨询时使用。回顾了 2004 年 8 月至 2011 年 8 月期间由一位外科医生对 IHs 患者进行手术的患者，以确定与手术干预相关的患者（年龄、性别、出生史）和 IH 特征（大小、位置）。将数据与 Hemangioma Investigator Group（HIG）发表的数据进行比较。使用学生 t 检验、比值比和逻辑回归分析进行统计学分析。在 196 名转诊患者中，有 112 名患者接受了手术。女性患者明显居多（3.5:1）。三分之二的患者（64.9%）首次就诊年龄≤2 岁，但大多数患者在 2 至 3 岁之间进行了手术（52.7%；平均滞后时间为 11 个月）。有 18 名患者在≤1 岁时进行了手术。有早产史的 IH 患者需要手术干预的风险增加（比值比 2.124，CI 1.31-3.44；p<0.0012）。大多数（84.7%）切除的 IH 位于头部或颈部，明显高于 HIG 数据的分布（62.2%；p<0.0001）。与颈部以下的 IH 相比，切除的头颈部 IH 较小（平均大小分别为 8.85cm²和 22.35cm²，p=0.017）。早产与手术干预的风险增加相关。与颈部以下的 IH 相比，头颈部 IH 更有可能被切除，而且切除的阈值更小。
