论文部分内容阅读
目的探讨聚焦超声治疗婴幼儿血管瘤临床效果及适宜能量参数。方法 2009年1月-2010年9月,收治60例血管瘤患儿。男23例,女37例;年龄3～30个月,平均10个月。病变部位:头面部24例,躯干15例,四肢16例,臀部2例,会阴部1例,颈部、腹部及上肢多发2例。瘤体范围为0.8 cm×0.6 cm～6.0 cm×5.0 cm。根据应用的聚焦超声能量不同,随机分成A、B、C 3组(n=20)。采用超声治疗仪以3～5 mm/s速度连续辐照血管瘤表面,频率9 MHz,脉冲1 000,重叠10%,扫描5个来回,A、B、C组功率分别为3.5、4.0、4.5 W;治疗3次为1个疗程,每次治疗间隔1个月,观察治疗结束6个月后效果及辐照区皮肤破溃、瘢痕发生率。结果所有患儿均完成1个疗程治疗,治疗结束6个月按照血管瘤疗效判定标准评定,各组比较差异无统计学意义(P>0.05)。A组无皮肤破溃及瘢痕;B组4例(20%)辐照区皮肤出现不同程度破溃,经换药后遗留浅表瘢痕;C组7例(35%)辐照区皮肤出现溃烂,经换药后遗留较明显瘢痕。B、C组皮肤破溃及瘢痕发生率均明显高于A组(P<0.05)。结论聚焦超声辐照是治疗婴幼儿血管瘤有效方法之一,能量以不超过3.5 W为宜。
Objective To investigate the clinical effects and appropriate energy parameters of focused ultrasound in the treatment of infantile hemangiomas. Methods From January 2009 to September 2010, 60 children with hemangiomas were treated. 23 males and 37 females; aged 3 to 30 months, an average of 10 months. Lesions: head and face in 24 cases, trunk in 15 cases, limbs in 16 cases, 2 cases of hip, perineum in 1 case, neck, abdomen and upper extremities in 2 cases. The tumor range of 0.8 cm × 0.6 cm ~ 6.0 cm × 5.0 cm. Depending on the applied focused ultrasound energy, they were randomly divided into A, B and C groups (n = 20). The surface of hemangiomas was irradiated by 3 ~ 5 mm / s with the frequency of 9 MHz, 1 000 pulses, 10% overlap and 5 rounds of scanning. The powers of A, B and C were 3.5, 4.0 and 4.5 W; treatment for 3 times for a course of treatment, each treatment interval of 1 month, observe the effect of 6 months after the end of treatment and irradiation skin ulceration, the incidence of scarring. Results All children completed one course of treatment, and the therapeutic effect of hemangioma was evaluated 6 months after the end of treatment. There was no significant difference between the groups (P> 0.05). In group A, no skin ulceration and scarring occurred in 4 cases (20%) in group B. Skin ulceration occurred in 4 cases (20%) in group B. Skin ulceration occurred in 7 cases (35%) in group C , After the dressing left more obvious scar. The skin ulceration and the incidence of scar in B and C groups were significantly higher than those in A group (P <0.05). Conclusion Focused ultrasound irradiation is one of the effective methods for the treatment of hemangiomas in infants and young children. The energy should not exceed 3.5 W.