头颈部血管瘤及脉管畸形手术治疗专家共识

doi:10.19438/j.cjoms.2024.02.001

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (2): 105-117.doi: 10.19438/j.cjoms.2024.02.001

头颈部血管瘤及脉管畸形手术治疗专家共识

王延安^1,*, 秦中平^2,*, 郑家伟^1,*, 李春洁³, 刘少华⁴, 杨耀武⁵, 陈刚⁶, 陈伟良⁷, 刘学键⁸, 杜仲¹, 张雷⁹, 王业飞¹⁰, 王德明¹¹, 苏立新¹¹, 谢峰¹², 董长宪¹³, 郭磊¹⁴, 李凯¹⁵, 顾松¹⁶, 何悦¹, 张志愿¹

1.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
2.山东省临沂市肿瘤医院血管瘤脉管畸形专科,山东临沂 276001;
3.四川大学华西口腔医院头颈肿瘤外科,四川成都 610041;
4.山东大学齐鲁医院口腔颌面外科,山东济南 250012;
5.空军军医大学口腔医院口腔颌面-头颈肿瘤外科,陕西西安 710032;
6.武汉大学口腔医院口腔颌面-头颈肿瘤外科,湖北武汉 430079;
7.中山大学孙逸仙纪念医院口腔颌面外科,广东广州 510120;
8.山东省第一康复医院血管瘤中心,山东临沂 276029;
9.北京大学口腔医院口腔颌面外科,北京 100081;
10.上海交通大学医学院附属第九人民医院眼科,上海 200011;
11.上海交通大学医学院附属第九人民医院介入科,上海 200011;
12.上海交通大学医学院附属第九人民医院整复外科,上海 200011;
13.河南省人民医院血管瘤科,河南郑州 450003;
14.山东大学附属儿童医院血管瘤与介入血管外科,山东济南 250022;
15.复旦大学附属儿科医院外科,上海 201102;
16.上海交通大学医学院附属上海儿童医学中心普通外科,上海 200127

收稿日期:2023-12-18 修回日期:2024-01-04 发布日期:2024-03-27
通讯作者: 王延安,E-mail:yan.an.wang@sjtu.edu.cn;秦中平,E-mail:qinzhongping1962@163.com;郑家伟,E-mail:davidzhengjw@hotmail.com。^*共同通信作者
作者简介:王延安（1970-）,男,博士,主任医师,博士研究生导师
基金资助:
国家自然科学基金（81371164、81870780、82201085）; 上海市自然科学基金（23ZR1437900）

Expert consensus on surgical treatment of hemangiomas and vascular malformations in the head and neck

WANG Yan-an¹, QIN Zhong-ping², ZHENG Jia-wei¹, LI Chun-jie³, LIU Shao-hua⁴, YANG Yao-wu⁵, CHEN Gang⁶, CHEN Wei-liang⁷, LIU Xue-jian⁸, DU Zhong¹, ZHANG Lei⁹, WANG Ye-fei¹⁰, WANG De-ming¹¹, SU Li-xin¹¹, XIE Feng¹², DONG Chang-xian¹³, GUO Lei¹⁴, LI Kai¹⁵, GU Song¹⁶, HE Yue¹, ZHANG Zhi-yuan¹

1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Special Department of Hemangioma, Tumor Hospital of Linyi City. Linyi 276001, Shandong Province;
3. Department of head and neck oncology, West China Hospital of Stomatology. Chengdu 610041, Sichuan Province;
4. Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University. Jinan 250012, Shandong Province;
5. Department of Oral and Maxillofacial-Head and Neck Tumor Surgery, School of Stomatology, Air Force Medical University. Xi'an 710032, Shaanxi Province;
6. Department of Oral and Maxillofacial-Head and Neck Tumor Surgery, School of Stomatology, Wuhan University. Wuhan 430079, Hubei Province;
7. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital. Guangzhou 510120, Guangdong Province;
8. Department of Hemangioma Center, Shandong First Rehabilitation Hospital. Linyi 276029, Shandong Province;
9. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. Beijing 100081;
10. Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
11. Department of Intervention Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
12. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
13. Department of Vascular Anomalies, Henan Provincial People's Hospital. Zhengzhou 450003, Henan Province;
14. Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University. Jinan 250022, Shandong Province;
15. Department of Pediatric Surgery, Children's Hospital of Fudan University. Shanghai 201102;
16. Department of Pediatric Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine. Shanghai 200127, China

Received:2023-12-18 Revised:2024-01-04 Published:2024-03-27

摘要/Abstract

摘要： 血管瘤及脉管畸形是头颈部常见的良性脉管源性疾病,随着对非手术治疗方案的深入研究与广泛应用,大量患者在微创或无创情况下得以改善或治愈疾病,但在特定情况下,手术依然是血管瘤及脉管畸形综合序列治疗中不可替代的治疗手段。然而,针对头颈部血管瘤及脉管畸形,如何选择和应用手术诊疗技术,学术界尚未形成规范和共识。为进一步提高国内同行对头颈部血管瘤及脉管畸形的治疗水平,规范和统一手术治疗策略,本文汇集全国多所医学院校及附属医院相关专家的讨论意见,借鉴和参考国内外相关最新成果与诊治经验,从头颈部血管瘤及脉管畸形的临床诊断及术前准备、手术适应证及策略、术后护理及观察、术后常见并发症及处理、随访及社会心理支持等方面,制定此专家共识,以帮助和指导相关专业的医师开展规范化手术治疗。

关键词: 头颈部, 血管瘤, 脉管畸形, 手术治疗, 专家共识

Abstract: Hemangiomas and vascular malformations are common benign vascular diseases in the head and neck region. The evolution and extensive implementation of non-surgical therapeutic modalities have resulted in considerable improvement or even total remission in a significant number of patients in minimally invasive or non-invasive procedures. Nonetheless, under certain circumstances, surgical treatment remains an irreplaceable treatment modality within the comprehensive treatment sequence for hemangiomas and vascular malformations in the head and neck. However, there is no established standard or consensus in the academic community on how to choose and apply surgical treatment. Therefore, to enhance the treatment efficacy of hemangiomas and vascular malformations amongst domestic peers, and to standardize surgical treatment protocols, this consensus brings together the discussion opinions of relevant experts from many medical schools and affiliated hospitals nationwide. Based on the latest domestic and international research results and diagnosis and treatment experience, we formulated this expert consensus from the aspects of preoperative diagnosis and preparation, surgical treatment indications and strategies, postoperative care and observation, common complications and treatment after surgery, follow-up and social psychological support. It is expected to be used in clinical practice and to guide relevant professional doctors carrying out treatment.

Key words: Head and neck region, Hemangiomas, Vascular malformations, Surgical treatment, Expert consensus

中图分类号:

R739.8

王延安, 秦中平, 郑家伟, 李春洁, 刘少华, 杨耀武, 陈刚, 陈伟良, 刘学键, 杜仲, 张雷, 王业飞, 王德明, 苏立新, 谢峰, 董长宪, 郭磊, 李凯, 顾松, 何悦, 张志愿. 头颈部血管瘤及脉管畸形手术治疗专家共识[J]. 中国口腔颌面外科杂志, 2024, 22(2): 105-117.

WANG Yan-an, QIN Zhong-ping, ZHENG Jia-wei, LI Chun-jie, LIU Shao-hua, YANG Yao-wu, CHEN Gang, CHEN Wei-liang, LIU Xue-jian, DU Zhong, ZHANG Lei, WANG Ye-fei, WANG De-ming, SU Li-xin, XIE Feng, DONG Chang-xian, GUO Lei, LI Kai, GU Song, HE Yue, ZHANG Zhi-yuan. Expert consensus on surgical treatment of hemangiomas and vascular malformations in the head and neck[J]. China J Oral Maxillofac Surg, 2024, 22(2): 105-117.

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头颈部血管瘤及脉管畸形手术治疗专家共识

Expert consensus on surgical treatment of hemangiomas and vascular malformations in the head and neck

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