“三明治”式唇病变切除成形术治疗动静脉畸形巨唇症疗效分析  

Treatment effects of sandwich-shaped resection and cheiloplasty applied in macrocheilia secondary to arteriovenous malformations

作　　者：邰茂众 陈涛 葛春晓 徐振国 李克雷 秦中平 Tai Maozhong;Chen Tao;Ge Chunxiao;Xu Zhenguo;Li Kelei;Qin Zhongping(Special Department of Vascular Anomalies,Linyi Cancer Hospital,Linyi 276001,China)

机构地区：[1]临沂市肿瘤医院血管瘤专科,临沂276001

出　　处：《中华医学杂志》2022年第23期1771-1774,共4页National Medical Journal of China

摘　　要：总结“三明治”式唇病变切除成形术治疗动静脉畸形巨唇症的临床经验,观察其临床疗效和并发症。回顾性分析2018年1月至2020年10月在临沂市肿瘤医院接受手术治疗的27例动静脉畸形巨唇症患者的临床资料,其中男14例,女13例;中位年龄4.5岁(2~57岁);上唇18例,下唇9例。所有患者在手术前均接受过(外院或本院)5~10次的介入栓塞硬化治疗,巨唇外形改善均不明显,3例病变进展增大。本组病例均采用“三明治”式唇病变切除成形术治疗。共行“三明治”式唇病变切除成形术28例次(1例2次手术)。27例次患者一期切口愈合,1例部分黏膜坏死,后经换药后愈合。有2例分别于术后半年内局部复发。随访1~3年,远期疗效评价Ⅲ级(好)24例,Ⅱ级(中)3例,Ⅰ级(差)0例。“三明治”式唇病变切除成形术切口隐蔽,立体式切除病变彻底,能最大限度保留三维结构,术后外形和功能良好,远期疗效好,建议临床推广该手术方式。To summarize the clinical experience of sandwich-shaped resection and cheiloplasty in the treatment of macrocheilia secondary to arteriovenous malformation,and to observe its clinical efficacy and complications.The clinical data of 27 patients with macrocheilia secondary to arteriovenous malformation who received surgical treatment from January 2018 to October 2020 in Linyi Cancer Hospital were retrospectively analyzed.There were 14 males and 13 females.The median age was 4.5 years(ranged from 2 to 57 years).There were 18 cases of upper lip and 9 cases of lower lip.All patients had received interventional embolization sclerotherapy for 5 to 10 times before surgery with unsatisfied effect.There was no obvious improvement in the appearance,whereas 3 cases progressed presenting as abnormal enlargement.Sandwich-shaped resection and cheiloplasty was performed in all the patients.Histopathological examinations confirmed arteriovenous malformations in all 27 cases.Twenty-six patients received one course of operation and one received two courses.Partial mucosal necrosis occurred in 1 case and healed after dressing change,while the rest healed by first intention.Local recurrence occurred in 2 cases within 6 months after operation.A four-level standard was used for long-term evaluation,and 24 cases got gradeⅢ(good),three cases got gradeⅡ(moderate)after 1 to 3 years of follow-up.Sandwich-shaped resection and cheiloplasty can achieve good long-term efficacy with excellent appearance and function.Due to its advantages of hidden incision and three-dimensional resection and reservation,it is worthy of further clinical promotion.

关 键 词：唇疾病 巨唇症 动静脉畸形 手术 

分 类 号：R654.3[医药卫生—外科学]