4例儿童期颌骨动静脉畸形血管复通的再治疗  

Treatment of recanalization of maxillary and mandibular arteriovenous malformations in 4 pediatric patients

作　　者：黄子贤[1] 陈耀庭[2] 李世豪[1] 范松[1] 张大明[1] 汪延[1] 严凌健 陈伟良[1] 黄志权[1] 

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面外科,广东广州510120 [2]中山大学孙逸仙纪念医院介入科,广东广州510120

出　　处：《中国口腔颌面外科杂志》2017年第4期368-372,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的 :总结治疗儿童期上、下颌骨动静脉畸形治疗后血管复通的临床经验。方法 :回顾分析4例儿童期颌骨动静脉畸形(arteriovenous malformations,AVMs)患者的临床资料。所有患者均接受过至少26个月以上的颌骨AVM的多学科综合治疗,包括超选择性动脉内栓塞、颌骨骨腔内骨蜡填塞联合拔牙术,并应用计算机体层血管造影术(CTA)及数字减影血管造影术(DSA)证实AVM治疗后存在血管复通。对出现血管复通的患者,再次施以超选择性动脉内栓塞联合颌骨骨腔内骨蜡填塞及拔牙(如有必要)的综合治疗。结果:4例患者随访5~14个月,平均9.5个月,均预后良好,无治疗后搏动感存在或出血。结论:儿童期颌骨AVM综合治疗后,极少病例出现治疗后血管复通,再次应用超选择性动脉内栓塞联合颌骨骨腔内骨蜡填塞以及拔牙等综合治疗效果良好,值得推广应用。PURPOSE： This study reviewed our experience in treating recanalization of maxillary and mandibular arteriovenous malformations in 4 pediatric patients. METHODS： Four patients with maxillary or mandibular arteriovenous malformations （AVMs） were included in this study. All patients had undergone muhidisciplinary treatment of AVM at least 26 months before this review, including superselective intra-arterial embolization combined with bone wax packing （BWP）. Computed tomographic angiography and digital subtraction angiography （DSA） were performed to confirm the presence of recanalization. Superselective intra-arterial embolization combined with BWP and tooth extractions were performed in the patients with AVM recanalization. RESULTS： After confirmation of the recanahzation of AVM by DSA, the patients were treated with superselective intra-arterial embolization combined with BWP and tooth extractions （if necessary）. All patients were followed up for 5 to 14 months, with an average of 9.5 months. The outcome for all patients was good, and no patient complained of pulsatile sensation or hemorrhage after treatment. CONCLUSIONS： In the treatment for recanalization of maxillary and mandibular AVMs, reapplication of superselective intra-arterial embolization, combined with BWP, remains necessary.

关 键 词：动静脉畸形 复通 超选择性动脉内栓塞 骨蜡填塞 

分 类 号：R782[医药卫生—口腔医学]