动脉介入栓塞剂在儿童头颈部血管瘤栓塞治疗的表现及介入治疗中的意义  

Effects of Artery Intervention Embolic Agents in Children With Head and Neck Hemangioma

作　　者：程祝忠[1] 李迎春[2] 许国辉[1] 杨宇洁[1] 曹英[1] 何韧[1] 席晓秋[1] 

机构地区：[1]四川省肿瘤医院影像科,成都610041 [2]中国人民解放军452医院核医学科

出　　处：《中华妇幼临床医学杂志（电子版）》2008年第5期48-51,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨动脉介入栓塞剂在儿童头颈部血管瘤栓塞治疗的表现及介入治疗中的指导意义。方法研究对象为2003年6月至2006年8月在四川省肿瘤医院采取介入治疗的56例头颈部血管瘤儿童,男性患儿为35例,女性为21例(年龄为2个月至16岁)。41例血管瘤发生于头面部,15例发生于颈肩部。栓塞术中采用动脉选择或超选择性插管技术,根据造影显示血管的类型,选择不同类型栓塞材料,向靶血管内分别释放栓塞材料组合为:①弹簧圈(cook);②弹簧圈+明胶海绵颗粒+硬化剂;③明胶海绵颗粒+明胶海绵条+硬化剂;④明胶海绵条+硬化剂,实施动、静脉瘘(arteriovenous fistula,AVF),畸形血管网和导入动脉的栓塞治疗。介入栓塞治疗术后随访1～5年。结果本组47例患儿(84%,47/56)血管瘤通过栓塞治疗后痊愈,随访1～5年疗效稳定;9例(16%,9/56)随访2^+年显示,介入栓塞治疗有效。结论根据儿童头颈部血管瘤动脉介入造影表现,应用弹簧圈+明胶海颗粒+硬化剂,明胶海绵颗粒+明胶海绵条+硬化剂,明胶海绵条+硬化剂等组合栓塞剂,对儿童头颈部血管瘤介入栓塞治疗有重要指导意义。Objective To investigate the artery intervention embolic agent effects on pediatric patients with head and neck hemangioma, and their implications in interventional treatment. Methods 56 pediatric patients with head and neck hemangioma who accepted interventional treatment were admitted to the Sichuan Cancer Hospital from June 2003 to August 2006, including 35 boys and 21 girls （aged from 2 months to 16 years old）. There were 41 pediatric patients with head and face hemangioma, and 15 pediatric patients with neck and shoulder hemangioma. Selective and superselective artery intubation were adopted. Different types of embolic materials were used according to artery types identified with the artery angiography. Embolism material combinations were （1） steel wire collar; （2） steel wire collar ＋ gelatin sponge particles ＋ hardener; （3） gelatin sponge particles ＋ gelatin sponge strips ＋ hardener; and （4） gelatin sponge strips ＋ hardener. Such materials were used for embolism treatment of arteriovenous fistula （AVF）, vascular net malformation, and access artery. A follow-up of 1- 5 years was conducted after the interventional embolism therapy. Results 47 pediatric patients （84%, 47/56） were cured by embolism therapy in a follow-up of 1 - 5 years, with stable therapeutic effects. Interventional embolism therapy was effective in the other 9 pediatric patients （16%, 9/56） in a follow up of 2 years or more. Conclusion According to the interventional artery angiography in children patients with head and neck hemangioma, the interventional embolism therapy with the following combinations provided the satisfactory effects ： （1） steel wire collar＋ gelatin sponge particles ＋ hardener ; （2） gelatin sponge particles ＋gelatin sponge strips ＋ hardener; （3） gelatin sponge strips ＋ hardener.

关 键 词：儿童 头颈部血管瘤 栓塞剂 血管造影术 数字减影 

分 类 号：R739.91[医药卫生—肿瘤] R581.1[医药卫生—临床医学]