目的总结血管瘤的临床特点,探讨血管瘤及血管畸形的变化规律和处理原则。方法2000年3月-2007年8月,收治血管瘤及血管畸形患儿2957例,其中采取非手术治疗2097例(非手术组),手术治疗860例(手术组)。手术组男441例,女419例;年龄6个月～18岁,中位年龄5岁。非手术组血管瘤1950例,男575例,女1375例,年龄1个月～14岁,中位年龄6个月;血管畸形147例,男67例,女80例;年龄2～17岁,中位年龄7岁。非手术组中1525例血管瘤患儿及147例血管畸形患儿仅接受门诊随访观察而未实施医疗干预,余425例血管瘤患儿在观察中接受曲安奈德与地塞米松联合注射治疗。分别将各组患儿年龄、病程、处置方法及疾病转归进行分析。结果1525例未干预血管瘤患儿表现出明显增生、静止和消退完成期特点,消退完成期522例(中位年龄16个月),消退率为34%;425例接受曲安奈德与地塞米松联合注射治疗的患儿中,383例(90%)进入消退完成期。147例血管畸形患儿无异常增快及自然消退者。手术切除的860例患儿随年龄增大,血管瘤构成比逐渐下降,血管畸形构成逐渐上升。结论血管瘤转归具有特殊的生物学特点。对于多数不涉及重要功能的中小型血管瘤不宜过早进行干预,可在医师监测下严密观察,争取自然消退。对于生长于特殊部位以及面积较大,生长速度过快的难治性血管瘤,为防止并发症发生及在自行消退之前出现更大损害,可积极实施适当医疗干预。血管畸形不能自然消退,应根据具体情况适时干预。 Objective To summarize the clinical features of hemangiomas and to explore the changing rules and treatment principles of hemangiomas and vascular malformations. Methods From March 2000 to August 2007, 2957 children with hemangiomas and vascular malformations were admitted. Among them, 2097 cases (non-operation group) and 860 cases (operation group) were treated by non-surgical treatment. The operative group of 441 males and 419 females; aged 6 months to 18 years old, the median age of 5 years. Non-surgical group of hemangiomas 1950 cases, 575 males and 1375 females, aged 1 months to 14 years old, the median age of 6 months; 147 cases of vascular malformations, 67 males and 80 females; aged 2 to 17 years old, The median age of 7 years old. Non-operation group of 1525 cases of hemangiomas and 147 cases of vascular malformations were only outpatient follow-up observation without medical intervention, and the remaining 425 cases of hemangiomas were observed in patients receiving triamcinolone acetonide and dexamethasone injections. The age, course of disease, treatment and disease outcome of each group were analyzed respectively. Results A total of 522 patients (median age, 16 months) with a complete regression, quiescence, and regression of complete disappearance were found in 1525 non-intervention hemangiomas with a regression rate of 34%. 425 patients received triamcinolone acetonide and gemcitabine Among the children treated with metoclopramide, 383 (90%) entered the phase of regression. 147 cases of vascular malformations in children without abnormal increase and spontaneous regression. Surgical removal of 860 cases of children with age, hemangioma composition ratio decreased gradually, vascular malformations gradually increased. Conclusion Hemangiomas have special biological characteristics. For most does not involve important functions of small and medium-sized hemangioma should not be premature intervention can be closely observed under the supervision of physicians for natural subsidence. For patients with refractory hemangiomas that grow in special sites and are large and rapidly growing, appropriate medical intervention can be actively implemented to prevent complications and cause more damage before they subside. Vascular abnormalities can not be subsided, timely intervention should be based on the specific circumstances.