Huang Baicheng, a plastic surgeon at Hsinchu Branch of National Taiwan University Hospital, said that at least 5% of the world's population is affected by vascular diseases and their complications, but the pathogenesis of vascular diseases is still unknown. "Vascular diseases are mainly divided into hemangioma and vascular malformation. The former is mainly vascular endothelial hyperplasia, while vascular malformation is abnormal vascular hyperplasia without excessive vascular endothelial hyperplasia, "Huang Baicheng said.
Hemangiomas mainly occur in infancy. Huang Baicheng explained that taking common hemangioma as an example, infantile hemangioma is the most common benign soft tissue tumor in infancy and the most common vascular birthmark. Some people also call it strawberry hemangioma, the incidence rate is about 2%, and the ratio of male to female is about 1:4. 80% is bright red on the epidermis and 20% is blue or does not change color under the skin.
60% hemangioma will appear in the head and neck, 25% in the trunk, 65,438+05% in the limbs, and most of them are sporadic. Huang Baicheng said that most hemangiomas were found two weeks after birth, and the rapid growth in the first nine months was a proliferative period, and the growth slowed down and shrank in 9-65,438+02 months. After 3.5 years old, about 50% disappeared, and some residues including skin capillaries may degenerate.
Huang Baicheng pointed out that although infantile hemangioma itself is benign, it can still cause complications in different parts, such as near the eyes, which may affect vision, nose may affect cartilage development, and ears may also cause appearance deformation, which requires careful examination and cannot be sloppy. (See more: "The baby has a bright red strawberry"! Three-step therapy for infantile hemangioma ")
Vascular malformations are difficult to deal with, and cross-departmental teams can tailor the treatment plan. Vascular malformation is quite complicated, which can be roughly divided into microvascular malformation, lymphatic malformation, primary lymphedema, arteriovenous malformation and so on. The doctor will make a diagnosis according to the medical history, physical examination and imaging examination, and formulate treatment methods. Huang Baicheng, for example, one of his patients, Ms. Cai, 68, had a swollen right eye for more than a year, resulting in drooping eyelids, uneven eyes and elevated intraocular pressure. So, she went to the ophthalmology clinic. After computerized tomography, nuclear magnetic resonance and related ophthalmological examination, it was found that Ms. Cai had a bony hemangioma on the upper right orbit after slicing. This disease is quite rare.
After the team consultation, the doctor arranged angiography and preoperative surgery simulation, and realized accurate reconstruction immediately after tumor resection by using 3D printing technology. The integrated operation went smoothly, and Ms. Cai recovered well. There was no recurrence during follow-up, and she was satisfied with her appearance symmetry.
Huang Baicheng said that the treatment of vascular diseases is quite difficult and complicated, which depends on cross-team cooperation and patient cooperation between doctors and patients. Therefore, it is suggested that patients with related problems find a hospital with a "vascular abnormality treatment team", which should include plastic surgery, vascular surgery, pediatric internal surgery, radiology, neurosurgery, ophthalmology, pathology and so on. In order to formulate different treatment methods according to different types of vascular diseases, such as oral or injection drugs, vascular embolization, laser therapy, tumor resection and reconstruction, so as to achieve staged and symptomatic treatment.