中华皮肤科杂志 ›› 2013, Vol. 46 ›› Issue (11): 822-823.

• 研究报道 • 上一篇    下一篇

肢体血管瘤伴Kasabach-Merritt现象的外科处理

刘大看1,2,马玉春3,郭晓楠4,朱晓爽4,董长宪4   

  1. 1. 河南省人民医院
    2. 郑州大学人民医院
    3. 郑州河南省人民医院血管瘤科
    4. 河南省血管瘤（畸形）诊疗中心；河南省人民医院
  • 收稿日期:2012-11-23 修回日期:2013-07-01 出版日期:2013-11-15 发布日期:2013-11-01
  • 通讯作者: 董长宪 E-mail:zzchangxiand@126.com
  • 基金资助:
    缺氧诱导因子-1在婴幼儿Kasabach-Merritt综合症中的表达及糖皮质激素联合尿素瘤体注射治疗对其相关因子表达的影响

Surgical treatment of hemangioma of limbs associated with Kasabach-Merritt phenomenon

  • Received:2012-11-23 Revised:2013-07-01 Online:2013-11-15 Published:2013-11-01

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摘要： 【摘要】 目的 探讨小儿肢体血管瘤并发Kasabach-Merritt现象的外科处理方法。 方法 回顾性分析并发Kasabach-Merritt现象的小儿肢体部血管瘤病例31例，下肢19例，上肢12例。血小板计数（2.6 ~ 60） × 109/L合并纤维蛋白原 < 1 g/L者26例，部分凝血酶原时间 > 50 s者21例。所有病例经糖皮质激素及药物治疗效果不佳，接受外科处理。 结果 治愈30例，死亡1例；术后1 ~ 3 d血小板计数恢复正常25例，3 ~ 7 d恢复正常4例， > 10 d恢复正常1例。 结论 对合并Kasabach-Merritt现象的小儿肢体血管瘤，应尽早进行外科处理，从而降低患儿死亡率。

关键词: 血管瘤, kasabach-merritt现象, 外科手术

Abstract: LIU Da-kan, MA Yu-chun, GUO Xiao-nan, ZHU Xiao-shuang, DONG Chang-xian. Department of Hemangioma Surgery, People′s Hospital of Zhengzhou University （Henan Provincial People′s Hospital）, Zhengzhou 450003, China Corresponding author: DONG Chang-xian, Email: zzchangxiand@126.com 【Abstract】 Objective To analyze the surgical treatment of hemangioma of limbs complicated by Kasabach-Merritt phenomenon in children. Methods A retrospective study was carried out on 31 children with hemangioma of limbs complicated by Kasabach-Merritt phenomenon. Lower limbs were affected in 19 patients, and upper limbs in 12 patients. Twenty-six patients showed decreased platelet count （（2.6 － 60） × 109/L） and fibrinogen level （< 1 g/L）, and 21 prolonged partial prothrombin time （> 50 seconds）. All the patients who had responded poorly to medications including glucocorticoids received surgical treatment. Results Of these patients, 30 were cured, and one died of massive blood loss. After surgical treatment, the platelet count returned to normal in 1 － 3 days in 25 patients, 3 － 7 days in 4 patients, and more than 10 days in one patient. Conclusions For pediatric hemangiomas of limbs complicated by Kasabach-Merritt phenomenon, surgical treatment should be given as early as possible so as to reduce mortality in patients.

Key words: Kasabach-Merritt phenomenon