Edgerton M T
Ann Surg. 1976 May;183(5):517-32. doi: 10.1097/00000658-197605000-00009.
Hemangiomas are the most common of all human birth defects. The author has reviewed a 25-year personal experience with treatment of over 1000 patients with a variety of common and rare developmental vascular anomalies. Attention is given to a more useful clinical classification of these disorders. The classification is intended to be helpful in estimating prognosis of the lesions and as a guide to the choice of therapy. Many treatment modalities are evaluated--some successful and some quite disappointing. Surgical excision, irradiation, CO2 freezing, sclerosing agents, cauterization, steroid therapy and watchful waiting are among the treatment methods evaluated. High dose--short course Prednisone therapy has proved to be a major new addition to the treatment of massive juvenile capillary hemangiomas. Numerous misconceptions have appeared in the medical literature. These are noted and a philosophic basis for present day management is suggested for each type angioma. The roles of growth, resolution, histologic picture and sense of deformity are considered in viewing the surgeon's approach to these difficult and challenging problems. Some evidence and speculations are offered as to the etiology, neurogenic influences and physiological dynamics of the various hemangiomas.
血管瘤是人类所有出生缺陷中最常见的。作者回顾了25年的个人经验，治疗了1000多名患有各种常见和罕见发育性血管异常的患者。文中关注了对这些病症更实用的临床分类。该分类旨在有助于评估病变的预后，并作为治疗选择的指南。文中评估了多种治疗方式——有些成功，有些则相当令人失望。评估的治疗方法包括手术切除、放射治疗、二氧化碳冷冻、硬化剂、烧灼、类固醇疗法和观察等待。高剂量——短疗程泼尼松疗法已被证明是治疗巨大型幼年毛细血管瘤的一项重要新方法。医学文献中出现了许多误解。文中指出了这些误解，并针对每种类型的血管瘤提出了当今治疗的哲学基础。在看待外科医生处理这些困难且具有挑战性的问题的方法时，考虑了生长、消退、组织学表现和畸形感的作用。文中提供了一些关于各种血管瘤的病因、神经源性影响和生理动态的证据及推测。
