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目的评价糖皮质激素治疗婴幼儿眼部毛细血管瘤的临床效果。设计回顾性病例系列。研究对象2007年11月到2009年4月于北京儿童医院眼科就诊治疗的婴幼儿眼部毛细血管瘤患者33例,其中表层毛细血管瘤12例,深层毛细血管瘤16例,混合型毛细血管瘤5例。方法对所有患者采取口服泼尼松或者瘤体局部注射复方倍他米松治疗。采用眼科多功能测量尺手工测量肿物大小,评价治疗前后血管瘤的大小变化及其有效率。彩色多普勒超声观察血管瘤形态。平均随访(7.42±3.22)个月。主要指标血管瘤的大小、治疗有效率。结果到最后一次随访时,血管瘤的平均体积从治疗前的(2.55±0.35)cm3缩小到治疗后(1.31±0.22)cm3(t=3.705,P=0.001)。表层、深层和混合毛细血管瘤治疗有效率分别为83.4%8、7.5%和40.0%。未发生严重并发症。结论局部注射必要时联合口服糖皮质激素可有效阻止眼部毛细血管瘤的增大并不同程度地减小肿瘤。
Objective To evaluate the clinical effect of glucocorticoid on ocular capillary hemangioma in infants and young children. Design retrospective case series. Participants 33 patients with ocular capillary hemangioma in infants and young children treated at Department of Ophthalmology, Beijing Children’s Hospital from November 2007 to April 2009, including 12 cases of surface capillary hemangioma, 16 cases of deep capillary hemangioma, 5 cases. Methods All patients were treated with oral prednisone or local injection of compound betamethasone. Using ophthalmic multifunctional measuring scale to manually measure the size of the tumor, evaluate the change of the size and the effective rate of the hemangioma before and after treatment. Color Doppler ultrasound observed hemangioma morphology. The average follow-up (7.42 ± 3.22) months. The main indicators of the size of hemangiomas, treatment efficiency. Results At the final follow-up, mean hemangiomas decreased from 2.55 ± 0.35 cm3 before treatment to 1.31 ± 0.22 cm3 after treatment (t = 3.705, P = 0.001). Surface, deep and mixed capillary hemangioma treatment rates were 83.4% 8,7.5% and 40.0%. No serious complications occurred. Conclusion Local injection of oral corticosteroids, if necessary, can effectively prevent the increase of ocular capillary hemangiomas and reduce the tumors to some extent.