无水乙醇硬化治疗头颈部静脉畸形的并发症及其预防  

Complications and prevention of ethanol sclerotherapy for venous malformation in head and neck

作　　者：王延安[1] 郑家伟[1] 张志愿[1] 范新东[1] 叶为民[1] 何悦[1] 苏立新[1] 竺涵光[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2009年第5期389-391,共3页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(08DZ2271100)~~

摘　　要：目的:分析无水乙醇硬化治疗头颈部静脉畸形的并发症,探讨其预防措施。方法:回顾83例应用经皮穿刺无水乙醇硬化治疗头颈部静脉畸形的临床资料,分析其并发症,探讨其发生原因及预防措施。结果:无水乙醇平均注射总量为15mL,28例(28/83)发生并发症,其中包括面神经麻痹12例,开口受限8例,皮肤、黏膜溃疡2例,乙醇过敏1例和血红蛋白尿5例;无肝肾功能损害及肺动脉痉挛、肺动脉栓塞等并发症。除1例发生面神经额支永久性麻痹外,其他所有并发症经相应处理均治愈。结论:无水乙醇硬化治疗头颈部静脉畸形是安全有效的方法,其并发症可以接受,但此项技术需由有经验的医师操作。PURPOSE： To analyze the complications of ethanol selerotherapy for venous malformation（VM） in head and neck, and investigate the preventive methods. METHODS： 83 eases of VM in head and neck regions who received absolute ethanol sclerotherapy were retrospectively reviewed. The complications were recorded and analyzed. RESULTS： Various complications developed during the procedure 28 in of 83 （33.7%） patients. The complications included ischemic bullae, tissue fibrosis, limitation of mouth opening, peripheral nerve palsy,allergy and hemoglobinuria. The major complications of temporary puhnonary hypertension, renal function impairment and pulmonary embolism did not occur. All incidences of complication were successfully managed with full recovery except one case of permanent facial nerve palsy that was present during 2-year follow-up. CONCLUSIONS： Absolute ethanol may be accepted as a safe and effective treatment method for sclerotherapy of venous malformation. The morbidity is acceptable. However, it should be reserved only for individuals and centers with expertise.

关 键 词：静脉畸形 头颈部 无水乙醇 并发症 硬化治疗 

分 类 号：R651[医药卫生—外科学] R653[医药卫生—临床医学]