超选择动脉栓塞治疗儿童Parkes-Weber综合征的临床疗效及并发症处理  

Clinical effect and complication management of superselective arterial embolization in children with Parkes-Weber syndrome

作　　者：刘新献 非凡 郭严延 周斌 王雅琪 柯嘉慧 LIU Xinxian;FEI Fan;GUO Yanyan;ZHOU Bin;WANG Yaqi;KE Jiahui(Department of Interventional Radiology/Hemangioma,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)介入放射科/血管瘤科,湖北武汉430016

出　　处：《实用放射学杂志》2025年第2期302-305,共4页Journal of Practical Radiology

摘　　要：目的探讨超选择动脉栓塞治疗儿童Parkes-Weber综合征(PWS)的临床疗效、术后并发症的预防及处理措施。方法选取经临床和影像学检查诊断的9例PWS患者,在全身麻醉下,采用Seldinger技术,将导管插管至各级分支动脉及病灶部位造影,视造影情况选取吸收性明胶海绵颗粒(或碘油)行靶血管栓塞治疗,伴有静脉畸形患者同时行局部硬化治疗,术后分别于1月、3月、6月及1年随访,观察临床疗效及并发症。结果9例患者均成功行介入治疗,动脉造影中多发分支动脉远端可见微小动静脉瘘存在,栓塞后动静脉瘘已关闭。介入治疗1月后复查,9例患肢色斑较前变淡,温度较前下降,腿围较前减小,疼痛较前减轻。3例患者术后第2~3天皮肤色泽加深,遂给予喜辽妥局部涂擦,3次/d,局部温水湿敷、患肢抬高体位、局部按摩等方式处理,1周后局部皮肤色泽逐渐恢复;2例患者术后第15天栓塞部位缺血坏死、皮肤色泽加深,有压痛,给予喜辽妥、金因肽、生理盐水、碘伏局部消毒,术后1月余皮肤破溃、结痂,术后1.5月皮肤溃疡好转、新生肉芽组织长出;1例术后1月复查病灶缩小不明显,行第2次介入治疗。结论超选择动脉栓塞治疗儿童PWS临床疗效显著,但要注意预防并发症的发生,并及时处理。Objective To explore the clinical efficacy of superselective arterial embolization in children with Parkes-Weber syndrome(PWS),and the prevention and treatment of postoperative complications.Methods Nine patients with PWS diagnosed by clinical and imaging examinations were selected.Under general anesthesia,the catheter was cannulated to all levels of branch arteries and lesion sites using the Seldinger technique.Absorbent gelatin sponge particle(or lipiodol)was selected according to the angiographic situation,and then target vessel embolization was performed.Patients with venous malformations were treated with local sclerotherapy at the same time.The patients were followed up for 1 month,3 months,6 months and 1 year after the operation to observe the clinical efficacy and complication.Results All 9 patients were successfully treated with interventional therapy.Arteriography showed that micro arteriovenous fistula existed at the distal end of multiple branch arteries,and the arteriovenous fistula had been closed after embolization.Review after 1 month of interventional therapy,the color spot of the affected limb became lighter,the temperature decreased,the leg circumference decreased,and the pain was relieved of all 9 cases.Three patients had skin deep color 2-3 days after the operation,so they were given hirudoid local smear,3 times/day,local warm water wet compress,raised limb position,local massage and other methods,and the local skin color gradually recovered after 1 week;On the 15th day after the operation,2 patients suffered from ischemic necrosis at the embolic site,skin color deepened,and tenderness.They were locally disinfected with hirudoid,aurantium peptide,normal saline,and iodophor.The skin broke and scabbed more than 1 month after the operation,the skin ulcer improved and new granulation tissue grew up 1.5 months after the operation;One case had no obvious reduction of the lesion 1 month after the operation,so the second intervention was performed.Conclusion Superselective arterial embolization is ef

关 键 词：超选择动脉栓塞 儿童 Parkes-Weber综合征 临床疗效 并发症 

分 类 号：R815[医药卫生—放射医学] R543[医药卫生—临床医学]