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目的:探讨不同类型淋巴管瘤的治疗方法及其可行性与优越性。方法:选择7例行淋巴管瘤治疗的新生儿,包括产时介入治疗(平阳霉素局部注射)1例,产时手术(子宫外产时处理-EXIT联合产房外科手术)3例,生后第2天行介入治疗3例,对各种治疗方法的适应证及临床效果进行分析并对新生儿的预后进行随访,进一步评价各种治疗方法的可行性与优越性。结果:产时介入治疗1例患儿瘤体局部注射药物后未出现相关并发症,术后3天与其母同时出院,肿瘤明显缩小;术后1个月返院复查,肿瘤局部仅留小结节,未给予再次注射药物;术后半年～1年返院复查肿瘤无复发,生长发育正常。产时手术3例,术后恢复良好,随访2～3年,患儿生长发育正常,其中2例术后1年内瘢痕较明显,术后2年后切口愈合良好,瘢痕几乎看不出。生后第2天行介入治疗3例,术后按期出院,未出现相关并发症,术后半年～1年返院复查,肿瘤无复发,生长发育正常。结论:对于瘤体大、压迫气管会造成新生儿窒息的淋巴管瘤可选择产时手术治疗;对于包绕重要血管神经的囊性淋巴管瘤,介入治疗为其首选治疗方法;产时介入治疗新生儿淋巴管瘤是可行的,最好在手术室有一定条件能完善急检血常规及胸片的前提下完成,以避免相关并发症的发生。对于综合治疗及宫内介入治疗仍需进一步研究。
Objective: To investigate the treatment of different types of lymphangioma and its feasibility and superiority. Methods: Seven newborns treated with lymphangioma were selected, including 1 case of inter-operative delivery (local injection of pingyangmycin), 3 cases of labor during operation (extra-uterine delivery -EXIT combined with delivery room surgery) On the second day, 3 cases were treated by interventional therapy. The indications and clinical effects of various treatment methods were analyzed and the prognosis of newborns was followed up to further evaluate the feasibility and superiority of various treatment methods. Results: Interventional therapy in one patient did not show any complications after local injection of tumor. After 3 days of operation, the patient was discharged with his mother at the same time. The tumor was significantly reduced. At 1 month after operation, he returned to the hospital for review. Day, did not give re-injection of drugs; six months to 1 year after surgery to review the tumor recurrence, growth and development of normal. During operation, 3 cases were cured during operation. The patients recovered well after 2 to 3 years of follow-up. The growth and development of the children were normal. Among them, 2 cases had obvious scar within 1 year after operation and the incision healed well 2 years after operation. Scar almost can not be seen. On the second day after birth, 3 cases were treated by interventional therapy. The patients were discharged on schedule after operation. No complications were found. The patients were admitted to the hospital for half a year to one year after operation. The tumors showed no recurrence and their growth was normal. Conclusion: For the large tumor, compression of the trachea can cause neonatal asphyxia lymphangioma can choose operation-time surgery; for encircling the important vascular nerve cystic lymphangioma, interventional treatment is the preferred method of treatment; Interventional labor Neonatal lymphangioma is feasible, it is best to have certain conditions in the operating room to improve the emergency inspection of blood and chest X-ray to complete under the premise to avoid the occurrence of complications. For comprehensive treatment and intrauterine intervention still need further study.