探讨经血管途径栓塞联合体外注射硬化剂治疗富血供型儿童血管瘤的临床效果。

选取38例富血供型儿童血管瘤患者，下颌部血管瘤28例，下肢大腿中段血管瘤4例，上肢指端血管瘤6例，经血管栓塞方案为：PVA+碘化油为11例、PVA+博来霉素为5例、PVA+碘化油+博来霉素为22例，后经体表透视下注入泡沫硬化剂混合物（博莱霉素1 ml+聚桂醇1 ml+空气4 ml+地塞米松1 ml+造影剂1 ml）到瘤体，记录介入治疗后血管瘤消褪情况及相关并发症。

全组患者未出现与介入治疗相关的严重并发症。18例患者经治疗后未行再次治疗，随访发现血管瘤基本消失；13例患者经经血管途径和经体表途径硬化治疗后血管瘤未完全消失，但局部症状基本消失，继续随访观察之中；4例患者经第2-3次只采用体外硬化治疗后也基本痊愈；3例经介入治疗后瘤体较前有缩小，但没有达到患者家属的满意度，其中1例失访，1例转外科手术治疗，1例继续口服药物观察之中。

经皮血管栓塞联合体外硬化剂注射可以成为富血供型儿童血管瘤的首选治疗方案。

To evaluate the clinical efficacy of vascular embolization combined with body surface injection of sclerosing agent for the treatment of high-flow hemangiomas in children.

A total of 38 cases were enrolled in the study, including 28 cases with maxillofacial hemangiomas, 10 cases with limbs hemangiomas, and 6 cases with upper limb hemangiomas. The treatment plans were as follows: PVA with iodinated oil in 11 cases, PVA with bleomycin in 5 cases, and PVA with iodinated oil and bleomycin in 22 cases. A foam sclerosing agent mixture (bleomycin+1 ml add polyol+4 ml add air+1 ml dexamethasone+1 ml contrast medium) was injected into the angioma through the surface, and the involuting condition and related complication were recorded.

There was no complication in all patients, among which 18 children’s hemangiomas faded away in regular follow-up after one treatment, 13 children’s hemangiomas partly faded away and local symptom disappeared in regular follow-up after transcatheter arterial embolization combined with body surface injection sclerotherapy, 4 children's hemangiomas faded away after body surface injection sclerotherapy for two or three times, 3 children's hemangiomas size decreased after transcatheter arterial embolization, 1 child loss to follow-up, 1 child went to sugery therapy, and 1 child was with drug therapy.

Transcatheter arterial embolization combined with body surface injection sclerotherapy is an important method which could be the preferred treatment in high-flow hemangiomas in children.