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首页> 外文期刊>American Orthoptic Journal >Infantile Hemangioma: Treatment with Surgery or Steroids
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Infantile Hemangioma: Treatment with Surgery or Steroids

机译：小儿血管瘤：手术治疗或类固醇治疗

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Background and Purpose: Infantile hemangiomas (IH) often pose a significant risk to visual development. The lesions interfere with visual development by causing deprivation, astigmatism, or strabismus. Propranolol has been suggested as the new standard of care for treatment of IH. Alternative treatments such as intralesional steroids or surgery may need to be considered as equal or better treatments in some cases. The purpose of this study was to evaluate the potential risks and benefits of the various modalities for periocular IH. Method: A literature search was conducted for IH and propranolol, steroids, and surgery. The pertinent published literature on surgical resection of IH were reviewed and summarized. A retrospective analysis was also performed of the Vanderbilt Children's Hospital (VCH) surgical case series of twelve children who underwent surgical resection of a sight threatening IH. Results: Seven articles reported twenty or more patients treated with propranolol for IH. Many of these patients only had a partial response to propranolol in spite of months of treatment. In addition to the impact on IH, propranolol has been demonstrated to block neural pathways critical for learning and memory. Twelve children underwent surgical resection of a visual threatening IH at VCH. Two of these children had failed treatment with oral propranolol. The average time of surgery was 80 minutes. All twelve children had immediate resolution of the visual compromise. Conclusion: Early surgical intervention can successfully and quickly result in excellent visual and anatomic outcomes. Propranolol may have unrecognized neurocognitive impact and should be reserved for those lesions unamenable to surgical or local steroid injection.
机译：背景与目的：婴儿血管瘤（IH）通常对视力发育构成重大风险。病变通过引起剥夺，散光或斜视来干扰视觉发育。普萘洛尔已被建议作为治疗IH的新护理标准。在某些情况下，可能需要考虑使用替代疗法，例如病灶内类固醇或手术。这项研究的目的是评估眼周IH各种方式的潜在风险和收益。方法：对IH和心得安，类固醇和手术进行了文献检索。回顾和总结了有关IH手术切除的相关文献。还对范德比尔特儿童医院（VCH）的十二例儿童的外科手术病例进行了回顾性分析，这些儿童接受了手术切除威胁视力的IH。结果：七篇文章报道了20例或更多的普萘洛尔治疗IH患者。尽管经过数月的治疗，其中许多患者对普萘洛尔仍仅部分缓解。除了对IH的影响外，普萘洛尔还被证明可以阻断对学习和记忆至关重要的神经通路。 12名儿童在VCH接受了视觉威胁性IH的手术切除。其中两个孩子口服普萘洛尔治疗失败。平均手术时间为80分钟。所有十二个孩子都立即解决了视觉障碍。结论：早期外科手术可以成功，快速地产生出色的视觉和解剖结果。普萘洛尔可能具有无法识别的神经认知作用，应保留给那些无法通过手术或局部类固醇注射治疗的病变。

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