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血管肿瘤和畸形的流行病学、诊断与治疗

Epidemiology, diagnostics and treatment of vascular tumours and malformations.

作者信息

Wójcicki Piotr, Wójcicka Karolina

机构信息

Clinic of Plastic Surgery, Wroclaw Medical University, Polanica Zdrój, Poland.

出版信息

Adv Clin Exp Med. 2014 May-Jun;23(3):475-84. doi: 10.17219/acem/37149.

Abstract

Vascular tumours and vascular malformations are common vasculose anomalies characteristic for dissimilar clinical course, specific biological as well as immune cytological and histological properties. Vascular lesions classification system and their detailed division into groups and subgroups were elaborated and implemented in Rome, in 1996, during meeting of the International Society for the Study of Vascular Anomalies (ISSVA). It was based on modification of an earlier going division by Mullikien and Głowacki from 1982. Infantile hemangiomas are the most numerous group of benign tumours of mesenchymal origin. Vascular malformations appear definitely less often. They are composed of normal endothelium lined displastic vessels which originate from vascular tissue abnormal morphogenesis. In contrast, in hemangiomas, at the proliferation stage, increased, multiplication of endothelial cells is observed as well as of fibroblasts, mastocytes and macrophages. Infantile hemangiomas are usually not present at the moment of birth and white chloasma with superficial teleangiectasis appears which increases within 3-4 weeks and gets bright red colour and reveal very characteristic clinical course basing on intensive growth period and involution long process. Vascular malformations are observed most often at the delivery moment or they may appear at an early childhood. They enlarge proportionally along with the child's growth and their sudden expansion may be triggered by an infection, hormonal changes or trauma. Contrary to hemangiomas, they do not subside spontaneously and their abrupt increase may result in impairment or deformation of important anatomical structures. Infantile hemangiomas and vascular malformations require different and individual treatments which are often multi-stage procedures carried on in specialistic centres of plastic surgery, vascular surgery or maxillofacial surgery.

摘要

血管肿瘤和血管畸形是常见的血管异常,具有不同的临床病程、特定的生物学以及免疫细胞学和组织学特性。1996年,在国际血管异常研究学会(ISSVA)会议期间,在罗马制定并实施了血管病变分类系统及其详细的分组和亚组划分。它是基于对1982年Mullikien和Głowacki早期分类的修改。婴儿血管瘤是间充质起源的最常见的良性肿瘤组。血管畸形的出现肯定较少。它们由内衬发育异常血管的正常内皮组成,这些血管起源于血管组织的异常形态发生。相比之下,在血管瘤的增殖阶段,观察到内皮细胞以及成纤维细胞、肥大细胞和巨噬细胞的增加和增殖。婴儿血管瘤通常在出生时不存在,会出现伴有浅表毛细血管扩张的白色色斑,在3-4周内增大并变为鲜红色,并呈现出基于密集生长期和消退漫长过程的非常典型的临床病程。血管畸形最常在分娩时观察到,也可能在幼儿期出现。它们随着孩子的生长而成比例地扩大,其突然扩张可能由感染、激素变化或创伤引发。与血管瘤不同,它们不会自发消退,其突然增大可能导致重要解剖结构的损伤或变形。婴儿血管瘤和血管畸形需要不同的个体化治疗,这些治疗通常是在整形外科、血管外科或颌面外科的专科中心进行的多阶段手术。

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