CCTV International May 2004 10 15:5 1

1, Dong Changxian, deputy chief physician, director of hemangioma surgery in Henan Provincial People's Hospital, graduated from An Medical University, and has in-depth research on hemangioma diseases and rich experience in the treatment of hemangioma. Hemangioma surgical ward, as a key specialty in Henan Province, was approved to publish more than 20 papers. (Left)

2. Ma Yuchun, deputy chief physician, 1986 graduated from hemangioma surgery of Henan Provincial People's Hospital. Good at surgical treatment of hemangioma. In-depth research on the basic theory of hemangioma, published more than 20 papers, and won 2 scientific and technological achievements awards from the provincial science and technology commission. (right)

Moderator: Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about hemangioma.

Moderator: What is hemangioma?

Dong Changxian: Hemangioma is a congenital vascular disease, which is usually formed before birth (fetal period) and only appears or gradually appears after birth. Hemangioma lesions mainly include two situations, one is caused by the increase of blood vessels (hyperplasia), and the other is that the number of blood vessels does not increase, but the blood vessels become wider and thicker, which leads to the occurrence of lesions.

Moderator: Let's learn about the specific changes in blood vessels through a short film:

Narrator: Hemangiomas are commonly known as fetal hemorrhoids and vascular hemorrhoids. Traditionally, congenital cutaneous vascular lesions are collectively referred to as hemangioma in China. This disease is congenital, and it is the root of this disease from birth, which is very common in infants.

Moderator: Hemangiomas often grow on the face, is that right?

Ma Yuchun: More than 50% of hemangiomas grow in the head and face, some are prominent and some are not. In addition, hemangioma may grow in all parts of the body, including limbs, trunk, viscera and brain.

Moderator: In fact, our column paid attention to the situation of a child in early 2002. Let's take a look at our reporter's return visit:

Reporter: When I saw Xiaoyuexin again in Henan Provincial People's Hospital, she was three years old. I met Xiaoyuexin and her parents here two years ago, when she was only eight months old.

Mother (June 5438 +2002 10): The child's face turned a little red at 38 days. We went to Pingdingshan Hospital, and there was no medical condition to treat the disease at that time.

Reporter: Later, the child was diagnosed as hemangioma. Later, parents sought medical advice everywhere, gave their children injections and operated on their faces.

Father: Before the stitches were removed, the child's face was not too swollen. He was injected with isotopes and pingyangmycin. His face was swollen badly at once, only half of his nose was seen, and the whole thing was stuck in it. Face closure treatment, I turned my face around and sewed more than a dozen stitches.

Reporter: However, these therapeutic effects have not only failed to alleviate Xiaoyue's new condition, but have become worse and worse. When Xiaoyue came to the provincial hospital, her condition was very serious.

Mother: The doctor said that the child needed to be intubated and then operated, and that the child's illness was delayed. I felt very uncomfortable at that time.

Reporter: After more than a month of catheter intervention in urea treatment, although Xiaoyue's new hemangioma has healed, the scar on the child's face is always engraved in the child's heart.

Mother: Whenever I see my children playing with other children, I feel particularly uncomfortable. I'm sorry, son.

Reporter: Xiaoyuexin's mother said: "When the child grows up, give the child a cosmetic surgery."

Moderator: Among the patients you have treated, how do these children feel about this childhood experience when they grow up?

Dong Changxian: Although many children's hemangioma has been cured, they all have different degrees of scars on their faces, which will have some influence on their later lives more or less. Children abandoned by hemangioma are received almost every year.

Ma Yuchun: Some families only pay attention to the treatment of hemangioma, but not to the beauty problem. But as children grow up, this problem will affect the quality of life in the future.

Moderator: Let's look at the situation of another patient:

Reporter: Wei Nahui had a strange disease since she was a child, that is, her legs were particularly thick because she didn't even finish primary school.

Patient: At that time, my legs became thicker and thicker than my waist, and my legs were worn out.

Reporter: For her illness, the family were very worried about her and didn't go to see her, but they just didn't know what it was and where to go for treatment.

Father: I really didn't know where to see the children at that time.

Reporter: In recent years, her illness has almost dragged down the whole family. In March 2003, he was introduced to Henan Provincial People's Hospital, and was diagnosed as mixed hemangioma of both lower limbs after examination. As the doctor said, through urea injection, she has done four hemangioma resection operations in the past year. Before the last operation, Wei Nahui bought herself a pair of trousers in the mall. Wei Nahui was discharged from the hospital before the Spring Festival and is going to work in the south this winter.

Moderator: Why did Wei Nahui get hemangioma and her hind legs were so thick that she couldn't even put on her pants?

Dong Changxian: This is a mixed hemangioma with vascular hyperplasia in the early stage and lymphatic hyperplasia after a long time. If it continues to develop, it will stimulate adipose tissue proliferation because of lymphatic hyperplasia, forming this state. The patient left a deep impression on us. At that time, it was difficult to get in. Not only are his legs thick (each leg is thicker than his waist), but he also has a lot of friction. At that time, she could still wear skirts in summer and stay in bed in winter. When we met this patient, she was already 20 years old. Since she was 5 years old, her family has been seeking medical treatment everywhere, and the cause has never been diagnosed. More importantly, what effective treatment measures did she take? Many hospitals say she can't be cured. Later, through our understanding, we felt that it could still be treated and basically returned to normal.

Moderator: Our reporter said that you were particularly excited when Wei Nanhui was cured. Why?

Ma Yuchun: This patient is a special patient. I have never seen such a serious patient. We adopted a new method. In the past, we removed most of the subcutaneous layer of this disease, and it was difficult to completely remove it. This time, we all removed it and replanted the skin, which was basically cured at one time.

Dong Changxian: We also have a patient who is a taxi driver and half of his face is hemangioma. When he came to see a doctor, he said that few people took his car because they were afraid of him after seeing it. That's a red bump.

Moderator: It should be said that the condition of hemangioma is very clear. You can tell what disease it is almost at a glance, but why can't some doctors make a good diagnosis and treatment?

Dong Changxian: At present, the diagnosis and treatment of this disease is still a weak link in China. There are some shortcomings in theoretical research and treatment, and some small hospitals have even less understanding of this disease.

Ma Yuchun: In many cases, this disease started as a little red dot, and then it grew up and developed rapidly, especially when children were young.

Dong Changxian: There are many types of hemangioma, including capillary hemangioma in China, which can be divided into strawberry hemangioma and rosacea hemangioma. In addition, there are cavernous hemangioma and tendinous hemangioma. At present, we divide hemangioma into two categories, most of which (80%) are tumors, which are caused by vascular proliferation. The other is vascular malformation, the number of blood vessels does not increase, but the blood vessels are deformed and widened. These two different types of hemangioma should be treated accordingly. Malformed hemangiomas are generally treated by surgery, and tumors are generally treated by drug injection. Basically, more than 90% can be completely cured.

Ma Yuchun: For tumor-like hemangioma, we generally treat it with urea as the core drug, and there are some surgical methods, but mainly drugs. More than 80% of tumor-like hemangioma can be completely cured by drugs. There are some big complications or complications that cause some coagulation mechanisms of the body, such as bleeding patients, and we will take surgical methods.

Moderator: We look at the method of tumor-like hemangioma through a film:

Mother: The child's face is swollen as big as a walnut. At first, I thought I needed surgery, but the doctor said that injection therapy could be cured.

Narrator: There are two ways to treat urea. One is to inject urea directly into the lesion site, so that the vascular endothelial cells shrink, stop growing, denature and disappear, and achieve the purpose of root removal.

Mother: When my child was born, a red dot grew on his face. It turned red at the full moon and became bigger after a while. Much better after the operation. Now

Narrator: Another method is to insert the tube into the external carotid artery after the operation, so that the drug can act more directly and make the vascular cells in the afterlife atrophy, degenerate and disappear.

Mother: After my child was born, there was a small piece of red on my arm. Later, it became bigger in a week or so, and it was as big as a fist in ten days.

Narrator: If the volume and area of hemangioma are too large, although the vascular endothelial cells of Lai have atrophied and degenerated after urea injection, the human body cannot absorb them at this time. In this case, surgery should be used to completely remove them.

Moderator: We talked about three methods, including urea, intervention and surgery, which are all aimed at the treatment of tumor-like hemangioma. Under what circumstances can I inject?

Dong Changxian: For tumor-like hemangioma, we generally adopt comprehensive treatment based on urea. Relatively small tumor-like hemangioma can be cured by local injection of urea.

Ma Yuchun: Interventional therapy is generally applied to special parts, mainly the face, especially the fast and big face.

Dong Changxian: Interventional therapy is directly inserted into the artery of hemangioma, which is highly targeted.

Compere: Does urea injection have side effects on human body?

Ma Yuchun: Urea itself is a metabolite of human body, and it has no toxic and side effects on human body. Urea injection can inhibit the growth of tumor cells and be slowly absorbed by human metabolism after atrophy.

Dong Changxian: In fact, urea injection therapy was first tested with Celosia cristata, which is a tissue rich in blood vessels. After the test, the comb will shrink and turn white.

Moderator: Can hemangioma be found early?

Ma Yunchun: Yes. Most hemangiomas are difficult to find at birth, and many have only one little red dot at 1-2 weeks, and then grow up gradually. Some can be found at birth. One of the earliest treatments for hemangioma is to shorten the treatment time. In addition, the damage to the human body, especially the skin, may be small, and there is basically no trace after recovery.

Dong Changxian: Tumor hemangioma is usually a red dot at the beginning. If it is deformed, it is usually erythema. Deformities grow very rapidly, especially in the first few months of the year. If parents find suspicious red spots and erythema, experienced doctors can identify them after being sent to the hospital. Early treatment will be better.

Moderator: Some netizens asked his child, who is now three months old and had hemangioma on his cheek when he was born. Now he is a strawberry capillary tumor the size of a grain of rice. Should he be treated or observed? What treatment?

Ma Yunchun: It should be treated as soon as possible. This kind of hemangioma with mild symptoms can be treated by multiple injections of urea.

Moderator: Ms. Zhang from Guangdong, 32 years old. When my wife was born, she had a hemangioma on her face. It's getting bigger and bigger now. Can it be treated?

Dong Changxian: Judging from the age, it should be a malformed hemangioma. This malformed hemangioma develops from childhood to adulthood, and the older it is, the faster it develops. Of course, the early manifestation is erythema, then it will protrude and finally grow into a grape shape.

Ma Yunchun: Generally, this kind needs surgical resection. It seems that the effect of drug treatment is not good in clinic. We classify these hemangiomas as malformations, and some of them need skin grafting.

Moderator: To what extent can skin grafting be restored?

Dong Changxian: The skin graft will not be exactly the same as the normal color. Although this kind of plastic surgery has developed rapidly, it will leave some traces more or less after all.

Moderator: Ms. Qiao from Jiangxi, 34 years old. My daughter is four months old. Two weeks after birth, she found a bulge on her left breast, a soft and hard lump the size of a jujube, and the size of an egg when she was three months old. The local hospital diagnosed cavernous hemangioma. The doctor said that surgical resection might hurt the breast. What should we do?

Ma Yunchun: First of all, we must make a clear diagnosis. This situation is generally diagnosed as a tumor in our hospital. We can cure it by simple medication. If the breast is removed by surgery, it will definitely affect the child's life.

Dong Changxian: The so-called cavernous hemangioma is an early classification method. In the early stage, hemangioma growing under the skin is called cavernous hemangioma. In fact, it is very important to distinguish between tumor hemangioma and malformed hemangioma. If it is deformed, it needs surgery. The patient's condition is a tumor and urea can be injected.

Moderator: Mr Yao of Guangdong Province, 3 1 year old. My son is three months old. There is an egg-sized cavernous hemangioma on the outside of the left upper arm. After three times of cryotherapy, the surface skin was frozen rotten, but the hemangioma continued to grow. How to treat it?

Ma Yunchun: If the patient's hemangioma was very small at birth, it is so big now at three months. We generally think it is a tumor-like hemangioma. Freezing only affects the epidermis, but has little effect on the deep subcutaneous layer. In this case, urea can only be injected locally.

Dong Changxian: If the injury caused by this cryotherapy is on the face, it will definitely seriously affect the quality of life of children in the future. Cryopreservation, laser and isotope are all surface treatments. Especially isotope therapy has certain risks. Some people lack a correct understanding and think that it is just a general plaster, just stick it on. It is wrong to do so.

Moderator: Specifically, what other treatments are not recommended?

Ma Yunchun: For tumor hemangioma, radiotherapy and isotope therapy are not recommended because of side effects and environmental pollution. Some hospitals without treatment conditions can use cryotherapy or laser, which may be effective for non-facial hemangioma and superficial hemangioma.

Moderator: Do patients need other tests after being diagnosed in the hospital?

Dong Changxian: Under normal circumstances, experienced doctors can easily identify the general situation, but for hidden situations, further examination is needed, such as color Doppler ultrasound to check whether the number of blood vessels has increased, magnetic resonance imaging for deeper bones or muscles, and angiography.

Moderator: Ms. Sun from Heilongjiang, 56 years old. I have two hemangioma on my liver. There are no symptoms. Do I still need treatment?

Ma Yunchun: If it is an hemangioma on the liver, it is asymptomatic. B-ultrasound examination is below 5 cm, which can be observed regularly and does not need immediate treatment.

Moderator: Outpatient time Dong Changxian Monday morning, Wednesday afternoon, Ma Yuchun Tuesday afternoon and Thursday morning; Hospital Tel: (037 1)558079 1

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