超声引导下硬化联合射频消融治疗儿童复杂淋巴管畸形的疗效分析  

Efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the treatment of complex lymphatic malformations in children

作　　者：张雨昂 董刚[1] 吴洁[1] 孙嘉敏 张姗姗[1] 彭梦凡 岳文文 Zhang Yu'ang;Dong Gang;Wu Jie;Sun Jiamin;Zhang Shanshan;Peng Mengfan;Yue Wenwen(Department of Ultrasound,the First Afiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院超声科,郑州450000

出　　处：《中华实用儿科临床杂志》2023年第8期591-594,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学适宜技术推广项目(SYJS2020101)。

摘　　要：目的:探讨超声引导下硬化联合射频消融治疗儿童复杂淋巴管畸形(LM)的安全性及疗效。方法:回顾性分析2018年6月至2021年10月郑州大学第一附属医院使用超声引导下硬化联合射频消融治疗的21例复杂LM患儿的临床资料,记录术中、术后并发症发生情况。术后1、3、6、9、12、18、24个月行影像学检查,观察复发情况,计算病灶体积及其缩小率,分析其疗效。采用Friedman检验比较术前与术后不同时间点病灶体积、术后1个月与之后不同时间点病灶体积缩小率。结果:本组共纳入21例患儿。其中男12例,女9例;年龄1个月至5岁6个月,中位年龄23个月。21例患儿共计26处LM均顺利完成治疗,术中、术后未出现器官损伤等严重并发症。1处腹部LM患儿术后感染,置管引流3周后感染得到控制。3例患儿4处LM于术后3个月或6个月随访时复发,但病灶体积均较术前明显缩小,继续硬化治疗1~3次后治愈。术前与术后1、3、6、9、12、18、24个月病灶体积比较差异均有统计学意义[222.26(159.57,316.40)cm 3比43.06(22.74,62.53)cm 3、31.56(15.49,45.94)cm 3、25.21(9.63,36.22)cm 3、19.80(6.79,28.81)cm 3、12.80(3.93,20.38)cm 3、7.13(0,11.34)cm 3、2.79(0,4.93)cm 3;均P<0.05],术后1个月与术后3、6、9、12、18、24个月病灶体积缩小率比较差异均有统计学意义[79.36(73.30,87.81)%比85.40(81.09,91.61)%、88.85(84.70,93.61)%、91.67(87.87,95.05)%、94.15(94.47,97.35)%、97.11(95.02,100.00)%、99.04(97.93,100.00)%;均P<0.05];患儿均随访至术后24个月,均达到治愈标准。结论:超声引导下硬化联合射频消融治疗儿童复杂LM微创、安全、疗效确切。ObjectiveTo investigate the safety and efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the complex lymphatic malformations(LM)in children.MethodsThe clinical data of 21 children with complex LM treated with ultrasound-guided sclerotherapy combined with radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from June 2018 to October 2021 were retrospectively analyzed.Intraoperative and postoperative complications were recorded.Imaging examinations were performed at 1,3,6,9,12,18,24 months postoperatively to observe the recurrence,the volume of the lesions and their reduction rate were calculated,and the efficacy was analyzed.Friedman test was used to compare the lesion volume at different time points before and after surgery,and the reduction rate of lesion volume at 1 month postoperatively and other time points after surgery.ResultsA total of 21 children were included in this study,among them,there were 12 males and 9 females,age range from 1 month to 5 years and 6 months,with a median age of 23 months.A total of 26 LM in 21 children were successfully treated,and no serious complications like organ damage occurred during and after surgery.One patient with abdominal LM had a postoperative infection,which was controlled by 3 weeks of catheter drainage.Four LM in 3 children recurred at 3 or 6 months after surgery,while all lesions were significantly narrowed down than those before surgery and they were cured after 1-3 sessions of continued sclerotherapy.There were significant differences in the lesion volumes before surgery and 1,3,6,9,12,18 and 24 months postoperatively[222.26(159.57,316.40)cm3 vs.43.06(22.74,62.53)cm3,31.56(15.49,45.94)cm3,25.21(9.63,36.22)cm3,19.80(6.79,28.81)cm3,12.80(3.93,20.38)cm3,7.13(0,11.34)cm3,and 2.79(0,4.93)cm3;all P<0.05].There were significant differences between the volume reduction rates at 1 month postoperatively and 3,6,9,12,18,and 24 months postoperatively[79.36(73.30,87.81)%vs.85.40(81.09,91.61)%,88.85(84.70,93.61)%,9

关 键 词：超声引导 硬化治疗 射频消融 淋巴管畸形 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.5[医药卫生—诊断学]