2019 November
婴幼儿血管瘤都会自己消退干净吗？
——对未经治疗的深部型和混合型面部婴儿血管瘤进行的7年随访研究
（J. Dermatol.，IF: 3.377）
张世仁，乔丛蓁，仇雅璟，林晓曦 等
A 7-year follow-up study on untreated deep or mixed facial infantile hemangioma in East-Asian patients: When propranolol was not yet an option
Shih-Jen Chang, Congzhen Qiao, Yajing Qiu, Xiaoxi Lin, et al.
J. Dermatol., 2019, 46: 962-966
Background: Infantile hemangioma (IH) is a type of benign tumor that develops during infancy spontaneously involutes after 1 year of age. Before the introduction of propranolol in 2008, some patients with IH were instructed to wait for the involution without treatment. This long-term follow-up study was conducted to assess the prognosis of East-Asian children with untreated deep or mixed facial IH. Skin sequelae were assessed by comparing images obtained during the patients’ first last visits in our clinic. Possible factors were assessed for their association with IH prognosis.
婴儿血管瘤是一种在婴儿时期出现，并在1岁后自发消退的良性肿瘤。在2008年使用普萘洛尔治疗婴幼儿血管瘤之前，主要的治疗方法就是等待瘤体自然消退。这项长期随访研究旨在评估未经治疗的深部型和混合型面部血管瘤的东亚患儿的预后。我们通过患者在门诊第一次和最后一次就诊时所拍摄的照片来评估皮肤损伤情况，以及相关因素与血管瘤预后之间的关系。
Methods: The mean follow-up time was 7.4 years. Among the 48 patients with deep or mixed facial IH, 26 (54%) achieved complete involution without sequelae 22 encountered various sequelae, including telangiectasia (36.3%), fibrofatty residue (68.2%), scars (4%).
我们平均随访时间为7.4年。在48例未经治疗的深部型和混合型面部血管瘤中，有26例（54％）达到完全消退，没有皮肤损伤，有22例发生了不同种类的皮肤损伤，包括残留毛细血管扩张（36.3％），纤维脂肪残余组织（68.2％）和疤痕（4％）。

表一 瘤体部位及消退后所呈现的皮肤外貌类型
Results: The complete regression rate of deep or mixed IH occurring in the central facial region was significantly lower than for those in the perifacial region (33.3% vs 66.7%, respectively, x2, P = 0.025). Further, the most common sequelae in this area are fibrofatty residue.
在面部中央区域发生的深部型或混合型血管瘤的完全消退率显著低于面部周围区域（分别为33.3％和66.7％，x2，P = 0.025）。此外，该区域最常见皮肤损伤类型是纤维脂肪残余组织。

图一 婴幼儿血管瘤消退率和部位之间的关系图
红色：消退不完全，残留皮肤损伤
灰色：消退完全，呈现正常皮肤外貌
结论：林晓曦研究团队在对深部型和混合型面部婴儿血管瘤的自然病程进行为期7年随访研究中发现，近半数的混合型和深部型血管瘤不会完全消退，会遗留一些皮肤损伤，并且这些瘤体多发生在面中央区域。