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中华介入放射学电子杂志 ›› 2016, Vol. 04 ›› Issue (04) : 211 -215. doi: 10.3877/cma.j.issn.2095-5782.2016.04.006

所属专题: 文献

血管介入

泡沫加液体混合硬化治疗低流量脉管畸形的初步研究
杨伟洪1,(), 周汝明1, 向先俊1, 何健龙1   
  1. 1. 518053 深圳,香港大学深圳医院影像科介入诊疗中心
  • 收稿日期:2016-10-12 出版日期:2016-11-01
  • 通信作者: 杨伟洪

A preliminary study on polidocanol foam and liquid mixed sclerosis therapy in the treatment of low flow vascular malformation

Weihong Yang1,(), Ruming Zhou1, Xianjun Xiang1, Jianlong He1   

  1. 1. The Diagnosis and Treatment Interventional Center of the Shenzhen Hospital of the University of Hong Kong, Shenzhen 518053, China
  • Received:2016-10-12 Published:2016-11-01
  • Corresponding author: Weihong Yang
  • About author:
    Corresponding author: Yang Weihong, Email:
引用本文:

杨伟洪, 周汝明, 向先俊, 何健龙. 泡沫加液体混合硬化治疗低流量脉管畸形的初步研究[J]. 中华介入放射学电子杂志, 2016, 04(04): 211-215.

Weihong Yang, Ruming Zhou, Xianjun Xiang, Jianlong He. A preliminary study on polidocanol foam and liquid mixed sclerosis therapy in the treatment of low flow vascular malformation[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2016, 04(04): 211-215.

目的:

探讨采用聚桂纯泡沫加博莱霉素液体混合硬化的模式治疗低流量脉管畸形的效果。

方法:

回顾性分析2013年5月—2015年7月共105例脉管畸形患者资料,年龄3个月~60岁,平均(26.8±2.0)岁。所有患者通过充盈缺损法,经皮穿刺脉管畸形注射聚桂醇泡沫+博莱霉素液混合硬化模式。治疗过程采用超声或透视监控,按照空气∶聚桂醇体积比2∶1制成泡沫硬化剂,单次治疗聚桂纯最大剂量20 ml,博莱霉素液15 mg。对比治疗后症状以及影像变化,疗效评价参照Achauer标准。

结果:

研究病例中脉管畸形以静脉畸形最多见,占81.9%,其中硬化治疗的临床治愈率:I型>Ⅱ型>Ⅲ型>Ⅳ型。Ⅳ型静脉畸形,K-T综合征硬化治疗效果较差。105例患者治疗的临床有效率为41.9%,临床治愈率为48.6%,无皮肤坏死、器官功能受损等严重并发症出现。

结论:

初步研究表明聚桂纯泡沫加博莱霉素液有协同硬化作用,能提高硬化治疗疗效。充盈缺损法配合超声和透视监控可提高治疗准确性,预防并发症。

Objective:

To explore the clinical efficacy of polidocanol foam and bleomycin liquid mixture hardening therapy mode in the treatment of low flow vascular malformation.

Methods:

Relative data of 105 cases of vascular malformation from May 2013 to July 2015 were collected for this study. These patients aged from 3 months to 60 years old, with an average of 26.8 ±2.0 years. Through the method of filling defect, they were given percutaneous injection of polidocanol foam + bleomycin solution under the guidance of ultrasound or fluoroscope. With the air to lauromacrogol ratio as 2:1, to make foam hardening solution. a single therapy dose is not over 20 ml, while bleomycin liquid is under 15 mg. The outcome was evaluated based on the changes of symptoms and improvement of scores by Achauer standard.

Results:

The venous malformation is the most common in this group of vascular malformations, accounting for 81.9%. The interventional therapy efficacy is evaluated as: type I > type II > type III > type IV. Type IV venous malformation and K-T syndrome effect is the worst scenario. After the treatment, the clinical effectiveness reached to 41.9%, with clinically cured rate of 48.6%. There were no serious complications observed.

Conclusions:

Polidocanol foam plus bleomycin liquid solution has synergistic hardening effect, by way of filling defect and with ultrasound and fluoroscopy monitoring, it can improve the accuracy of the treatment and prevention of complications for low flow vascular malformation.

表1 105例患者脉管畸形种类和病变部位分布
表2 105例脉管畸形患者硬化治疗效果观察[例(%)]
图1 典型病例1手术前后变化
图2 典型病例2手术前后变化
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