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1、得保松联合甲氨蝶哙注射治疗婴幼儿血管［摘要］目的：探索得保松联合甲氨蝶哙综合注射治疗婴幼儿血管瘤的安全有效、创伤小的方法。方法：应用瘤体间质内得保松混合甲氨蝶吟注射，或栓塞硬化结合得保松混合甲氨蝶吟注射治疗表浅和深部血管瘤。结果：治疗婴幼儿血管瘤共178例。皮肤的浅表血管瘤经间质内得保松及甲氨蝶哙注射治疗102例，其中共4次注射治疗消退38例，共2次治疗消退45例，共3次治疗消退19例，无1例出现皮肤破溃。深部血管瘤经栓塞硬化联合得保松混合甲氨蝶吟注射治疗72例，其中共1次治疗消退62例，共2次治疗消退10例。血管瘤合并KM综合征4例，共1次治疗
2、2例，共2次治疗2例血小板恢复正常，瘤体消退，无复发；栓塞硬化治疗中3例岀现皮肤水泡及部分皮肤干性坏死，均自行愈合。结论：得保松联合甲氨蝶哙瘤体间质注射或结合栓塞硬化注射治疗婴幼儿血管瘤，能够控制其快速生长，其疗效安全可靠,创伤小，形态功能恢复良好，具有美容效果。［关键词］血管瘤；得保松；甲氨蝶哙；注射；栓塞硬化［中图分类号］R732.2［文献标识码］A［文章编号］100&6455(2009)03-0346-03InjectionofDiprospanwithMethotrexate(MTX)inthetreatmentofinfantilehe
3、mangiomaOUYANGTian-xiang,HUANGYing-ying,CHENGHui-ping,YUJie,XIAOYan,LINJun,ZHANGQian(DepartmentofPlasticSurgery,XinhuaHospital,AffiliatedtoShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200092,China)Abstract:ObjectiveToexploreasafe,effectiveandminimallyinvasivetherapyofin
4、fantilehemangiomawiththecombinedinjectionofDiprospanplusMethotrexate(MTX).MethodsApplytheinjectionofDiprospanwithMTXininterstitialtissueofthehemangioma,orcombinewiththeembolo-sclerotherapyandDiprospanplusMTXaccordingtothedepthoflesion(deeporsuperficial).Results178patientswith
5、infantilehemangiomaweretreated.102superficiallesionsinvolvingskinlayershadinjectionofDiprospanwithMTXintointerstitialtissue,amongwhich38patients5lesionsdecreasedafter1injection,45casesdecreasedafter2injections,19casesdecreasedafter3timesoftreatment,withnocaseofskinulceration.
6、72deeplesionshadcombinedembolo-sclerotherapywithDiprospanplusMTX,amongwhich62patier)ts,lesionsdecreasedafter1injection,10casesdecreasedafter2injections.4casesofKasabach-MerrittSyndrome(KMS):2caseshad1injectionandother2had2injections,allshowedgoodresultswithplateletcountbackto
7、normal,lesionsdisappearanceandnorecurrence・3deeplesionsgotskinblistersandlocaldrynecrosisaftertreatmentandallhealedupspontaneous!y.ConclusionTheinjectionofDiprospanwithMTX,oracombinationofembolo-sclerotherapyandDiprospanplusMTXintreatinginfantilehemangiomacanwellcontrolthegro
8、wthofthelesion.It'sasafe,effective,minimallyinvasivewaytoretainforma
