介入硬化治疗外科术后复发或残留静脉畸形的疗效分析  

Analysis of efficacy of interventional sclerotherapy for recurrent or residual venous malformations after surgery

作　　者：汪松 齐炜炜 潘登 陈晓莉 李诗余 尹传高 WANG Song;QI Weiwei;PAN Deng;CHEN Xiaoli;LI Shiyu;YIN Chuangao(Department of Imaging,Anhui Children's Hospital,Hefei 230022,China)

机构地区：[1]安徽省儿童医院影像科,安徽合肥230022

出　　处：《实用放射学杂志》2023年第9期1514-1517,共4页Journal of Practical Radiology

摘　　要：目的 探讨外科手术后复发或残留静脉畸形(VM)的介入硬化治疗的疗效.方法 回顾性分析手术后复发或残余的VM患儿 15 例,均行 MRI检查被证实病变复发或残留,并在数字减影血管造影(DSA)引导下经皮穿刺后注入硬化剂进行介入治疗,如果病灶范围较大且比较分散的,需选择多点穿刺;4 周后如患儿未达到治愈标准的,再次入院行介入硬化治疗.15 例患儿共接受硬化治疗 45 次,平均 3.6 次,治疗成功率 100%;病灶位于上肢 6 例,下肢 8 例,背部 1 例.15 例患儿术后未出现严重的并发症,部分患儿在术后 48 h内出现不同程度的肿胀,或伴有疼痛,大部分不需要处理均在第 2 天出院.术后平均随访 0.5~2 年,无复发.结果 按国外 Achauer等及国内的疗效评判通用标准,将疗效分为 4 级:Ⅰ级 0 例;Ⅱ级 2 例;Ⅲ级 8 例;Ⅳ级 5 例.结论 介入硬化治疗外科术后复发或残留 VM具有操作简单、住院时间短、可重复、高效且安全等诸多优点,值得临床推广应用.Objective To investigate the efficacy of interventional sclerotherapy for recurrent or residual venous malformations(VM)after surgery.Methods A tofal of 15 children with recurrent or residual VM after surgery were analyzed retrospectively.All the 15 children were confirmed to have recurrent or residual lesions by MRI,and sclerotherapy was injected under the guidance of digital subtraction angiography(DSA)after percutaneous puncture.If the lesions were large and relatively dispersed,which should select multi-point punctures.If the patient did not meet the cure criteria after 4 weeks,who was readmitted to the hospital for interventional sclerotherapy.A total of 45 times(mean of 3.6 times)were received sclerotherapy,and the success rate was 1o0%.The lesions were located in the upper limb in 6 cases,lower limb in 8 cases,and back in 1 case.No serious complications occurred in 15 patients after interventional sclerotherapy.Some of the children had varying degrees of swelling or pain within 48 hours after interventional sclero-therapy.Most of them did not need to be treated and were discharged the second day.The average follow-up was O.5-2 years,and there was no recurrence.Results The postoperative efficacy was evaluated according to Achauer et al and the general efficacy evaluation standard at home.The efficacy was divided into 4 levels.None were grade I;2 cases of grade II;8 cases were grade II;5 cases were grade IV.Conclusion Interventional sclerotherapy for recurrent or residual VM after surgery has many advantages,such as simple opera-tion,short hospital stay,repeatability,high efficiency and safety,which is worthy of clinical application.

关 键 词：静脉畸形 介入硬化治疗 无水乙醇 聚多卡醇 

分 类 号：R543.6[医药卫生—心血管疾病] R815[医药卫生—内科学]