弹簧钢圈联合无水乙醇栓塞硬化治疗复杂型静脉畸形  

Embolo-sclerotherapy with coils and absolute ethanol in complex venous malformations

作　　者：刘珍银 张靖 李海波 申刚 陈昆山 刘浪 周少毅 蒋贻洲 Niu Chuanqiang Liu Zhenyin Zhang Jing Li ttaibo Shen Gang Chen Kunshan Liu Lang Zhou Shaoyi Jiang Yizhou(Department of Interventional and Vascular Anomalies, Guangzhou Women Children Medical Center, Guangzhou 510623, China)

机构地区：[1]广州市妇女儿童医疗中心介入、血管瘤科,510623

出　　处：《中华放射学杂志》2016年第12期963-967,共5页Chinese Journal of Radiology

摘　　要：目的：探讨弹簧钢圈联合无水乙醇栓塞硬化治疗复杂型静脉畸形的安全性及有效性。方法回顾性分析13例临床诊断为复杂型静脉畸形患儿的临床资料。患者男4例、女9例；年龄2.3～13.0岁，平均（5.0±0.5）岁。行介入治疗，DSA导引下局部穿刺造影确诊为复杂型静脉畸形，测量瘤巢静脉直径及出口横径，路途下穿刺针穿刺病灶，植入合适弹簧钢圈，再次重复局部穿刺造影，注入适量无水乙醇至瘤巢消失或缩小95%以上。治疗后随访0.4～4.0年，平均随访时间（2.3±0.6）年。随访项目包括临床表现、影像资料、治疗效果及并发症。结果本组患儿病灶位于颈部8例（其中合并颌面部低回流病灶3例），背部4例，胸壁1例；硬化栓塞治疗1～8次/例，共36次；治愈9例、部分缓解3例、无缓解1例。本组1例钢圈植入时移位至肺动脉，术中及时行介入抓捕术取出；4例病灶表浅者出现病变部位疼痛及皮肤片状红斑；1例因肿物巨大缩小不明显，疗效不满意。所有患儿均未出现病灶局部溃疡、神经损害、肺栓塞等并发症。结论弹簧钢圈联合无水乙醇治疗复杂型静脉畸形是一种安全且有效的治疗方法。Objective To evaluate the safety and effectiveness of embolo-sclerotherapy with coils and absolute ethanol in complex venous malformations. Methods The clinical data of 13 children with complex venous malformations treated by embolo-sclerotherapy with coils and absolute ethanol were retrospectively analyzed, including 4 males and 9 females with an average age of（5.0 ± 0.5）years. Direct puncture angiography under DSA was performed in complex venous malformations, then the nidus diameter parameters were measured for choosing suitable coils. Nidus were punctured by needle and coils were implanted under road map, absolute ethanol was finally infused untill the nidus structrue was disappeared or more than 95%. The follow-up time ranged from 5 months to 5 years, with an average of（2.3 ± 0.6）years. The clinical symptoms, imaging data, therapeutic effects, and postoperative complications were evaluated. Results The total treatment was 36 times with 1 to 8 times/case. Eight cases were located in neck （including 3 cases comebined with maxillofacia low reflux lesions）, 4 cases in back, and 1 case in chest wall. The lesions were cured in 9 cases, partially relieved in 3 cases, and no remission in 1 case. One coil was displaced to pulmonary artery, but was captured though interventional techniques. Transient pain and skin erythema were revealed in 4 cases with superficial lesions. The treatment effect was not satisfied in 1 patient because the huge tumor was not significantly decreased in size . No ulcer, nerve damage, pulmonary hypertension, and other complications occurred in all patients. Conclusion Embolo-sclerotherapy with coils and absolute ethanol is a safe and effective treatment option in complex venous malformations.

关 键 词：血管畸形 放射学 介入性 栓塞 治疗性 支架 无水乙醇 

分 类 号：R571.305[医药卫生—消化系统]