单点注射聚桂醇治疗婴幼儿颈部大囊型淋巴管畸形  

Single point injection sclerotherapy with polidocanol for macrocystic lymphatic malformations in necks of infants

作　　者：宁金波 谢义民[1] 刘渝[2] 陈强[1] 陈斌 NING Jinbo;XIE Yimin;LIU Yu;CHEN Qiang;CHEN Bin(Department of Pediatric Surgery;Department of Neonatal, Chongqing Three Gorges Central Hospital, Chongqing, 404000, China)

机构地区：[1]重庆三峡中心医院小儿外科,重庆404000 [2]重庆三峡中心医院新生儿科,重庆404000

出　　处：《中国耳鼻咽喉头颈外科》2018年第4期203-206,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：重庆市卫生和计划生育委员会医学科研项目资助(2016MSXM120)

摘　　要：目的探讨亚甲基蓝在验证大囊型淋巴管畸形囊间交通性的临床价值及采用单点注射聚桂醇硬化疗法治疗婴幼儿颈部大囊型淋巴管畸形的疗效。方法我院小儿外科、新生儿科2014年1月~2016年6月收治的17例婴幼儿颈部大囊型淋巴管畸形,通过囊内注射亚甲基蓝验证囊间交通性,认为囊间交通后行单点注射聚桂醇治疗,治疗后记录并发症发生情况,定期门诊复查彩超或MRI测量囊肿大小评价疗效。结果经囊内注射亚甲基蓝验证囊间交通性,共15例囊间交通并行单点注射聚桂醇硬化疗法治疗,显效7例(46.7%),有效5例(33.3%),无效3例(20%),总有效率80%。注射后出现面红2例(13.3%),发热2例(13.3%),皮疹1例(6.7%),局部肿胀1例(6.7%)。治疗前病变大小11~127 ml(平均51.7 ml),治疗后病变大小0~33 ml(平均10.5 ml)。无过敏性休克、皮肤坏死、神经血管损伤等并发症。结论亚甲基蓝用于验证囊间交通性,结合单点注射聚桂醇治疗婴幼儿颈部大囊型淋巴管畸形操作简单、可靠性高、疗效确切,无严重并发症,值得临床推广。OBJECTIVE To evaluate the clinical value of methylene blue in verifying the communication of the cysts of macrocystic lymphatic malformations（LMs）, and the curative effect of single point injection sclerotherapy with polidocanol for macrocystic LMs in necks of infants. METHODS Seventeen infants with macrocystic LMs in necks were treated at the Department of Pediatric Surgery and Neonatology in our hospital between January 2014 and June 2016. The cases, got through the verification of communication in methylene blue test, were treated with single point injection sclerotherapy with polidocanol. Complications were recorded after treatment, outpatient ultrasound or MRI were taken to measure the size of cysts on a regular basis and to evaluate the curative effect. RESULTS A total of 15 patients who passed methylene blue test underwent single point injection sclerotherapy treatment, with a result of excellent in 7 cases（46.7%）, effective in 5 cases（33.3%）, invalid in 3 patients（20%）, a total effective rate of 80%. Complications after injection included red face in 2 cases（13.3%）, fever in 2 cases（13.3%）, skin rash in 1 case（6.7%）, local swelling in 1 case（6.7%）. The lesion volume before treatment was range from 11 ml to 127 ml（mean 51.7 ml）, and after treatment from 0 ml to 33 ml（mean 10.5 ml）. There were no severe complications such as anaphylactic shock, skin necrosis, neurovascular injury. CONCLUSION Methylene blue test was a simple operation with high reliability to verify the communication of the cysts in macrocystic LMs. Single point injection sclerotherapy with polidocanol was remarkably effective for macrocystic LMs in necks of infants with no serious complications and was worthy of clinical application.

关 键 词：婴儿 淋巴管畸形 硬化疗法 聚桂醇 亚甲基蓝 

分 类 号：R726.5[医药卫生—儿科]