How to treat infantile hemangioma?

In recent years, hemangiomas in infants and young children have become a relatively common phenomenon, and parents of affected children are very worried about this, fearing that hemangiomas cannot be truly cured. In fact, infantile hemangioma is a benign tumor, but if the hemangioma continues to grow, it will still cause harm to the infant's body and even cause lesions in the infant's organs. So, what is the best way to treat infantile hemangiomas? Let’s take a look at it below:

If infantile hemangiomas grow rapidly, or involve important organs, or are accompanied by thrombocytopenia or bleeding tendency, prednisone can be taken. The dosage and usage of the above drugs must be followed according to the doctor's advice.

Treatment of hemangiomas should take into account factors such as the type of hemangioma, its location, and the patient's age. Current treatments include surgical resection, radiotherapy, cryotherapy, laser therapy, sclerotherapy injection, etc., and comprehensive therapy is generally used. Temporary observation may be considered for hemangiomas in infants and young children. In a few cases, the hemangiomas may disappear on their own. If they grow rapidly, they should be surgically removed in a timely manner. The effectiveness of radiotherapy is still uncertain and it may cause cancer, so it is rarely used nowadays.

The endothelial cells of the blood vessel walls of infants or children are still in an embryonic state and are more sensitive to hormone treatment. For rapidly growing cavernous hemangiomas in infants and young children, you can try injecting prednisolone into the tumor cavity, or taking prednisone orally, which can sometimes stop the growth of the tumor or significantly shrink it. Hemangiomas in adults are not sensitive to hormones. Cavernous hemangioma can be treated with 3% sodium morrhuate or other vascular sclerosing agents injected into the tumor cavity, which will cause fibrosis and closure of the tumor cavity, resulting in the shrinkage or disappearance of the tumor. During the injection, it is advisable to temporarily compress the surrounding tissues to block blood flow. The injection should be given once every 1 to 2 weeks. The injection dose depends on the size of the tumor. Generally, no more than 5 ml of sodium morrhuate is used at one time. If the therapeutic effect is not good, surgical resection or cryogenic treatment can be used. Argon ion laser irradiation can be tried for facial capillary hemangiomas. Laser or cryotherapy has a certain effect on submucosal cavernous hemangiomas, but is not effective for port-wine stain hemangiomas.

Resectable hemangiomas can be removed surgically. The removal of lip and tongue hemangiomas should be done without affecting function. If the tumor is too large, it should be removed in stages to avoid affecting function and appearance. After resection, a sclerosant can be injected into the remaining tumor. The wound after tumor resection can be directly sutured or repaired with a local skin flap transfer. Large wounds require free skin grafting, and perforated defects require tissue transplantation. During surgery for racemose hemangioma, the artery that communicates with the tumor should be ligated and cut off first. Sometimes, due to extensive lesions, one or both external carotid arteries need to be ligated during surgery to reduce bleeding. In recent years, the application of transcatheter arterial embolization (TAE) technology has shown a much better hemostatic effect than external carotid artery ligation. Bleeding is very likely to occur during surgery for central hemangioma of the jaw. Sufficient blood should be prepared, and hypothermic and antihypertensive anesthesia should be used to control bleeding. The surgery should also ligate one or both external carotid arteries, or directly ligate the inferior alveolar artery or internal maxillary artery. Of course, the use of TAE technology is better. Conservative surgery should be used whenever possible for central hemangioma of the jaw. If bleeding is effectively controlled, only the intrabone lesions can be scraped off, retaining more bone tissue to maintain the facial appearance. Osteotomy can also be used in cases where bone destruction is excessive and bleeding is difficult to control.

Currently, although there are many methods for treating hemangiomas, the treatment problem of some large hemangiomas has not yet been completely solved.

Surgery focuses on:

The professional surgical methods of surgeons are used to remove the diseased tissue to achieve the purpose of treatment. It is effective for independent and smaller lesions. Generally, the lesion area has rich vascular images and a large amount of blood. The amount of bleeding during the operation is extremely large, which often causes severe hemorrhagic shock. A large amount of whole blood transfusion is required during the operation. The operation is difficult and the risk level is high. At the same time, due to the inability to completely remove the blood after bleeding, the operation is forced to be terminated. Therefore, the postoperative recurrence rate is very high. The surgery focuses on removing part of the tumor, and the residual tumor, local deformity, loss and functional impairment. Long-term surgery is expensive and a burden that patients cannot bear. Facial skin capillary hemangioma can be combined with excellent cosmetic skin long-term transplantation to repair the lesion area. Therefore, the founder of regional surgical treatment should strictly master the indications and weigh the current surgical value before determining whether to choose the subject surgical cooperation treatment.

Cryotherapy:

This method of natural treatment of hemangiomas originated in the 1930s (it can be used for small-scale superficial lesions as appropriate). The operator uses the strong low temperature (-℃) caused by the volatilization of liquid nitrogen, which is usually below -℃, to successfully condense the skin hemangioma and the surrounding tissues in the affected area, forming ice crystals in the cells and causing the cells to rupture, disintegrate and die. Then, through the body's repair process, the hemangioma disappears. However, this method will leave local scars in the corners of the eyes, mouth, nose, and ears. After treatment, serious defects, deformities and functional disorders are often left behind. Because the intensity and depth of the freezing operation are difficult to control, the editorial board and the Shanghai tissues have different resistance to low temperatures, which leads to incomplete treatment and high recurrence rate, which directly affects the efficacy evaluation. The local scars, defects, deformities and functional disorders left behind are not the expected results of the patients. However, if such conditions do not occur, long-term treatment is often ineffective.

Radiation therapy:

The treatment principle of this article is to use the r-rays produced by radioactive elements to bombard the cell nuclei of the affected area to break the DNA and RNA chains, terminate the synthesis of nucleoproteins, cause cell death and disintegration, and then achieve the treatment purpose through the treatment of internal medicine tissue repair process. Commonly used clinical methods in Hangzhou include: shallow X-ray irradiation, local irradiation of cobalt, external application of strontium film, local injection of phosphorus colloid, etc. After international treatment, the treated area will leave atrophic scars after radiation damage and the epidermis will desquamate. For this kind of atrophic core tissue and atrophic scars caused by radiation irradiation, experts recommend key surgical resection, otherwise the possibility of cancer cannot be ruled out. Experts believe that treating physicians should try to avoid using radiotherapy during the treatment of hemangiomas.

Sclerotherapy:

This method is derived from the injection therapy of dried hemorrhoids in the old times. The principle is: inject the hardener into the hemangioma tissue (not into the blood vessels) to cause aseptic inflammation. After the swelling disappears, a local fibrosis reaction occurs, which shrinks or blocks the blood vessel cavity of the hemangioma. Commonly used drugs are: ① sodium corliver oleate; ② dried hemorrhoid injection; ③ alum injection; ④ dried alum and coptis injection; ⑤ sodium bicarbonate injection; ⑥ bleomycin and bleomycin; ⑦ boiling water injection therapy; ⑧ urea injection

Laser treatment:

We use the professional laser treatment equipment to coagulate the hemangioma tissue and achieve the purpose of treating the hemangioma in the area. However, the depth of laser abdominal treatment is generally controlled within the surface skin ~mm. If it exceeds mm, obvious scars will be produced. Therefore, it has a certain effect on superficial capillary hemangiomas, but it is easy to cause bleeding and scar deformities on deep hemangiomas.

Photosensitive laser therapy:

(Also known as photodynamic laser therapy) is to first inject a photosensitizer into the patient's blood vessels and then use a black light or long-wave laser to irradiate the hemangioma area. The photosensitizer is activated to produce a photochemical reaction and cause the vascular endothelium and stroma of the hemangioma to appear a photoactive process, which blocks the vascular lumen to achieve the purpose of coordinated treatment. However, this therapy must be strictly controlled during the treatment process, otherwise severe photosensitivity endothelial fibrosis and post-photosensitive retinitis will occur.

Interventional teaching and treatment experience: It means that under the guidance of "X", the arteriovenous catheter is introduced into the site of the hemangioma, and then the embolic agent is injected into the tumor to cause aseptic inflammation in order to achieve the effect of occluding the tumor blood vessels. It is often used for visceral hemangiomas such as liver hemangiomas. For deep hemangiomas in the trunk and limbs, it is often difficult to achieve the expected effect due to the limitations of the injection dose and dosage form as well as the characteristics of the hemangioma. When using it, the indications should be strictly controlled and the embolic agent should be avoided from flowing into other organs and tissues, especially.

Ultrasound microsurgery

Ultrasound micro-guided surgery is a new development in ultrasound medical technology for the treatment of hemangiomas. The treatment of hemangioma with minimally invasive surgery guided by color ultrasound is another feature of our research results. Under three-dimensional visualization, the drug can directly reach the central lesion of the hemangioma in the body, without the need for surgical treatment. It has high accuracy and efficiency, fast healing, and no recurrence. It has opened up a new approach for the clinical treatment of hemangiomas inside the body (liver, etc.) and on the surface of the body. With the adoption of minimally invasive mediated treatment technology, the treatment level and technological content of hemangiomas have been greatly improved, and it has been successfully applied to the treatment of hepatic hemangiomas and hemangiomas in various parts of the body surface.

The above is an introduction to how to treat hemangiomas in infants and young children. Once hemangiomas are found in infants and young children, they should be taken seriously and actively go to the hospital for examination and treatment. During pregnancy, pregnant women should pay close attention to their living and eating habits, and must quit smoking and drinking, so as to effectively prevent the occurrence of hemangiomas after the baby is born.