血管瘤是婴幼儿期常见的良性脉管肿瘤，60%～70%发生于头颈部。血管瘤的治疗方法多种多样，但迄今尚无一种方法适合于所有类型血管瘤的治疗。作者结合临床经验和文献复习，提出了头颈部血管瘤的治疗适应证及方法选择。认为较小、处于稳定期、消退期和消退完成期的血管瘤适于随访观察，增殖期血管瘤需按照循序渐进的原则进行积极治疗，表浅血管瘤可采用咪喹莫特软膏局涂、单纯激光或激光＋激素治疗；深部血管瘤可采用瘤内注射激素、平阳霉素治疗；多发性血管瘤、重症血管瘤或生长快速的血管瘤首选口服激素治疗，激素治疗无效时，采用干扰素-2a皮下注射；手术治疗不能作为早期血管瘤的首选治疗，而是用于血管瘤后期残存病变的切除或修整。

Hemangioma is common benign vascular tumor, with an incidence of 2%-3% in the neonate and 10% in the infancy after 1 year. The incidence of hemangiomas is approximately 22%-30% of preterm infants with birthweight less than 1 kg. The development of hemangioma is therefore supposed to be related to intra- and extra-uterine factors .

Females are affected more often than males by a ratio of 3:1-5:1. Hemangioma can occur everywhere in the body, nearly sixty percent of cutaneous hemangioma occurs on the head and neck, 25% on the trunk, and 15% on the extremities. Most of the lesions are focal and solitary, while 15%-20% are multiple with involvement of extracutaneous sites, including the liver, gastrointestinal tract, larynx, central nervous system, pancreas, gall bladder, thymus, spleen, lymph nodes, lung, urinary bladder, and adrenal glands.

Although infantile hemangioma is usually benign, its growth is very unpredictable due to endothelial cell proliferation. Infantile hemangioma has a varied appearance depending on the location of the lesion, the depth of the hemangioma and the size. Features of early proliferating hemangiomas (birth to 6 weeks) include blanching of the involved skin, followed by fine telangiectasias, and then a red or crimson macule or papule that often is surrounded by a faint halo of vascular blanching.

摘自：郑家伟,王延安,周国瑜,竺涵光,叶为民,张志愿.头颈部血管瘤治疗适应证的探讨.上海口腔医学,2007,16(4):337-342.

相关文献

Powell TG, West CR, Pharoah PO, Cooke RW. Epidemiology of strawberry haemangioma in low birthweight infants. Br J Dermatol,1987 May;116(5):635-41.

Preeyanont P, Nimsakul N. The Nd:YAG laser treatment of hemangioma.  J Clin Laser Med Surg. 1994 Aug;12(4):225-9. (PDF)

Landthaler M, Hohenleutner U, el-Raheem TA. Laser therapy of childhood haemangiomas. Br J Dermatol. 1995 Aug;133(2):275-81. (PDF)

Poetke M, Philipp C, Berlien HP. Flashlamp-pumped pulsed dye laser for hemangiomas in infancy: treatment of superficial vs mixed hemangiomas. Arch Dermatol. 2000 May;136(5):628-32.  (PDF)

Comi AM. Pathophysiology of Sturge-Weber syndrome. J Child Neurol. 2003 Aug;18(8):509-16. (PDF)

Vlachakis I, Gardikis S, Michailoudi E, Charissis G. Treatment of hemangiomas in children using a Nd:YAG laser in conjunction with ice cooling of the epidermis: techniques and results. BMC Pediatr. 2003 Apr 12;3:2.

Smolinski KN, Yan AC. Hemangiomas of infancy: Clinical and biological characteristics. Clin Pediatr, 2005; 44(9): 747-766. （PDF）

Bennett ML, Fleischer AB Jr, Chamlin SL, Frieden IJ. Oral corticosteroid use is effective for cutaneous hemangiomas: an evidence-based evaluation. Arch Dermatol. 2001 Sep;137(9):1208-13. (PDF)

Ulrich H, Baumler W, Hohenleutner U, Landthaler M. Neodymium-YAG Laser for hemangiomas and vascular malformations -- long term results. J Dtsch Dermatol Ges. 2005 Jun;3(6):436-40.  (PDF)

Sundine MJ, Wirth GA. Hemangiomas: An Overview. Clin Pediatr,2007; 46(3): 206-221. （PDF）