超声引导下经皮注射聚桂醇泡沫硬化剂治疗儿童淋巴管畸形的临床疗效及安全性分析  

Clinical efficacy and safety of ultrasound-guided percutaneous injection of laurylalcohol foam sclerotherapy in the treatment of lymphatic malformations in children

作　　者：宋丹[1] 郭磊[1] 王亮[1] 周洁[1] 刘壮[1] 李静[1] 张鑫[1] SONG Dan;GUO Lei;WANG Liang;ZHOU Jie;LIU Zhuang;LI Jing;ZHANG Xin(Department of Vascular anomalies and Interventional Radiology,Children’s Hospital Affiliated to Shandong University,Jinan 250022,China)

机构地区：[1]山东大学附属儿童医院血管瘤与介入血管外科,山东济南250022

出　　处：《医学影像学杂志》2024年第2期108-111,共4页Journal of Medical Imaging

基　　金：山东省济南市科技创新发展计划(临床医学科技创新计划)项目(编号:202134070)。

摘　　要：目的 探讨超声引导下经皮注射聚桂醇泡沫硬化剂治疗儿童淋巴管畸形(LMs)的临床效果及安全性。方法 选取在我院行超声引导下经皮注射聚桂醇泡沫硬化剂治疗的25例LMs患儿临床资料。巨囊型病变抽取囊液后,在超声实时监视下注入泡沫硬化剂;微囊型病变则在超声引导下直接弥散性注射泡沫硬化剂。以临床表现、术后超声检查或MRI表现为指标进行疗效评估。结果 25例LMs患儿中,巨囊型LMs 12例、混合型LMs 11例、微囊型LMs 2例,平均治疗次数为1.4次。所有患儿均随访6~12个月,其中显效18例、有效4例,治疗有效率为88%;未能获得临床改善3例(混合型2例、微囊型1例)。1例患儿因合并囊内出血而出现病变肿胀,后自行消退。所有患儿均未发生溃疡、疼痛、感染和功能障碍等严重并发症。值得注意的是,17例LMs在一次治疗中获得了有效缓解。结论 超声引导下经皮注射聚桂醇泡沫硬化剂治疗儿童LMs安全有效,且外观恢复满意,可作为巨囊型和混合型LMs的主要治疗方法。Objective To investigate the clinical effect and safety of ultrasound-guided percutaneous injection of laurylalco‑hol foam sclerosing agent in the treatment of lymphatic malformations(LMs)in children.Methods The clinical data of 25 chil-dren with lymphatic malformations treated with ultrasound-guided percutaneous injection of laurylalcohol foam sclerosing agent were retrospectively analyzed in our hospital.The foam sclerosing agent was injected under real-time ultrasound monitoring after extraction of cystic fluid in macrocystic lesions,while,microcystic lesions were injected with foam sclerosing agent directly un-der ultrasound guidance in a diffuse manner.Clinical manifestations and postoperative ultrasound or magnetic resonance imaging results were used as indicators for efficacy assessment.Results Of the 25 cases(12 males and 13 females)with lymphatic mal-formations,12 cases were macrocystic LMs,11 cases were mixed LMs,and 2 cases were microcystic LMs,with a mean number of treatments of 1.4.All patients were followed up for 6~12 months,there were 18 cases with obvious effects and 4 cases with ef-fective effects,with a treatment effectiveness rate of 88%;3 cases of LMs(2 mixed and 1 microcystic LMs)failed to improve clinically,and 1 case appeared swelling due to combining intracapsular hemorrhage,which subsided on its own.No serious com-plications such as ulceration,pain,infection and dysfunction occurred in any of the pediatric patients.Notably,17 cases of LMs achieved effective remission in a single treatment.Conclusion Ultrasound-guided percutaneous injection of laurylalcohol foam sclerotherapy is safe and effective in the treatment of LMs in children with satisfactory cosmetic recovery,which can be used as the primary treatment for macrocystic and mixed LMs.

关 键 词：淋巴管畸形 聚桂醇 泡沫硬化剂 儿童 介入性 放射学 

分 类 号：R738.6[医药卫生—肿瘤] R815[医药卫生—临床医学]