Objective To investigate the surgical treatment and curative effect of hemangioma and vascular malformation in body surface. Methods From May 2003 to December 2006, 145 patients with hemangioma or vascular malformation (81 males and 64 females, aging from 2 months to 40 years with median of 17 years) were treated with surgical therapy. The course of disease was from 2 months to 40 years. The locations were head and face in 85 cases, extremities in 34 casesand trunk in 26 cases. The size ranged from 1 cm × 1 cm to 27 cm × 24 cm. Wounds were sutured directly after lesions excision in 40 cases, were repaired with 3 cm × 2 cm-18 cm × 11 cm local flap transferring in 21 cases (donor site sutured directly in 18 and free skin grafted in 3) and with 5 cm × 3 cm-27 cm × 18 cm middle-thick skin graft in 84 cases (abdominal skin donor site sutured directly in 61, thigh skin donor site thin-partial-thickness grafted in 5 and skin in-situ regrafted in 18). Results The pathological results showed 38 cases of capillary hemangioma, 23 cases of venular malformation, 67 cases of venous malformation, 15 cases of arteriovenous malformation and 2 cases of lymphatic malformation. Six of 84 cases receiving free skin graft had partial skin necrosis; one case compl icating by skull exposure achieved heal ing after local fascial flap transferring and other 5 cases achieved heal ing by second intention after dressing changes. Other free skin graft survived. All the donor sites healed by first intention. All patients were followed up for 1-3 years. Recurrence occurred in 12 cases 6 months to 2 years after operation, including 4 cases of arteriovenous malformation, 7 cases of venous malformation and 1 case of venular malformation. They were cured after second operation. The others achieved good results with no recurrence. Conclusion Extensive and thorough excision was the effective way to cure hemangioma and vascular malformation in body surface. All cases should be followed up closely to deal with recurrence promptly.
【摘要】 目的 观察综合治疗体表血管瘤及脉管畸形的临床疗效。 方法 2008年1月-2010年9月，收治体表血管瘤和脉管畸形患者共205例。手术治疗156例，其中单纯手术治疗103例，合并介入治疗9例，硬化剂治疗44例；非手术治疗49例，其中介入治疗1例，硬化剂治疗38例，介入合并硬化剂治疗10例。术后随访6个月～3年。 结果 15例手术治疗患者于术后6个月～2年复发，其中单纯手术治疗患者10例（复发率9.71%），合并介入治疗患者2例（复发率22.22%），合并硬化剂治疗患者3例（复发率6.82%），均再次手术治疗后痊愈。9例非手术治疗患者于治疗后3个月～2年复发，其中8例硬化剂治疗患者，1例介入合并硬化剂治疗患者，均经手术治疗后痊愈。余患者未见复发。 结论 以手术治疗为主的综合治疗，是体表血管瘤和脉管畸形治疗的良好方法。【Abstract】 Objective To observe the clinical therapeutic efficacy of comprehensive treatment on body surface hemangioma and vascular malformations. Methods Between January 2008 and September 2010, 205 pateints with surface hemangioma and vascular malformation were treated. A total of 156 patients received surgical treatment, in whom 103 received surgery alone, 9 underwent combined interventional treatment, and 44 received combined sclerotherapy. There were 49 patients underwent non-surgical treatment, including intervention in 1, sclerotherapy in 38 involving 10 had combined sclerotherapy. The patients were followed up for 6 months to 3 years. Results A total of 15 patients who had received surgical treatment recurred 6 months to 2 years after the treatment, including 10 who had been treated with surgery alone (with the recurrence rate of 9.71%), 2 combined with interventional treatment (with the recurrence rate of 22.22%), and 3 combined with sclerotherapy (with the recurrence rate of 6.82%). They were all cured after reoperation. Nine cases of non-surgical treatment recurred 3 months to 2 years after the treatment, including 8 who had received sclerotherapy, and 1 combined with interventional treatment and sclerotherapy. Patients were all cured after surgery. The other patients had no recurrence. Conclusion Applying mainly on surgical treatment, the combined therapy is a good way for body surface hemangioma and vascular malformations.