DSA引导下经皮硬化术治疗儿童头颈部静脉畸形的临床价值  

The clinical effect of sclerotherapy in the treatment of venous malformations of the head and neck in children

作　　者：黄文雅[1] 肖天[1] 李春旺[1] 邹维[1] 金科[1] 张靖 

机构地区：[1]湖南省儿童医院放射科,长沙410007 [2]广州妇女儿童医疗中心介入科,广州510000

出　　处：《放射学实践》2015年第2期168-171,共4页Radiologic Practice

基　　金：湖南省科技厅基金项目项目(2013SK3219)

摘　　要：目的：探讨DSA引导下经皮硬化术治疗儿童头颈部静脉畸形的临床价值。方法：回顾性分析2009年1月-2013年12月我院收治的72例头颈部静脉畸形患儿的临床资料。所有患儿均行DSA引导下经皮硬化术治疗,根据瘤径采用分次、多种硬化剂联合治疗方法。较小的单发静脉畸形仅用无水乙醇治疗,而较大、多发静脉畸形联合应用聚桂醇治疗。末次治疗结束后行MRI检查评定疗效。结果：72例患儿进行2-6次治疗。42例治愈,21例显效,9例有效。随访（3个月-2年）均未发现静脉畸形复发。不良反应：2例皮肤破溃、坏死;4例表浅皮肤破溃,愈后无瘢痕;3例出现暂时性周围神经麻痹。结论：DSA引导下经皮硬化术是治疗儿童头颈部静脉畸形的有效方法。多种硬化剂联合、分次硬化治疗的原则有利于减少并发症和提高疗效。Objective：To summarize the treatment experiences of sclerotherapy in venous malformations of head and neck in children. Methods：The clinical data of 72 cases of venous malformation of head and neck in children were retrospectively analyzed. Multiple sclerosis agents and fractionized sclerotherapy were combined according to the size of the lesion. Small single venous malformations were given only ethanol treatment, while large or multiple venous malformations were given combined application with lauromacrogol treatment. Results：From 72 patients who received 2- 6 times of treatment, 42 cases were cured,in 21 cases the treatment was markedly effective, and in 9 cases the treatment was effective. 72 cases were followed up for 3 months to 2 years （mean 8 months）,no recurrence of venous malformation was observed. Adverse reactions：P, cases had skin ulceration or necrosis, 4 cases had superficial skin ulceration （no scar after healing） and 3 patients had temporary peripheral nerve paralysis. Conelusion： The advantages of percutaneous sclerotherapy in the treatment for venous malformation of head and neck in children are its safety and efficacy. Combining multiple sclerosis agent and fractionized sclerotherapy is helpful in reducing complications and improving the outcome.

关 键 词：静脉畸形 无水乙醇 硬化疗法 放射摄影术 介入性 儿童 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]