聚多卡醇泡沫硬化治疗儿童Puig'sⅠ型和Ⅱ型肛周静脉畸形临床研究

doi:10.3877/cma.j.issn.2095-5782.2021.01.007

中华介入放射学电子杂志 ›› 2021, Vol. 09 ›› Issue (01) : 41 -44. doi: 10.3877/cma.j.issn.2095-5782.2021.01.007

所属专题：文献；

血管介入

聚多卡醇泡沫硬化治疗儿童Puig'sⅠ型和Ⅱ型肛周静脉畸形临床研究

左松¹, 董长宪¹^,^†(

), 肖莉¹, 王彦林¹, 郭晓楠¹, 任腾飞¹

^1. 450003　河南郑州，河南省人民医院血管瘤科，郑州大学人民医院

收稿日期:2020-09-22 出版日期:2021-02-25
通信作者: 董长宪

Clinical study on sclerotherapy with polidocanol injectable foam in treatment of Puig's Ⅰ and Ⅱ perianal venous malformations in children

Song Zuo¹, Changxian Dong¹^,^†(), Li Xiao¹, Yanlin Wang¹, Xiaonan Guo¹, Tengfei Ren¹

^1. Department of Hemangioma and Vascular Malformation, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University, Henan Zhengzhou 450003, China.

Received:2020-09-22 Published:2021-02-25
Corresponding author: Changxian Dong

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目的

探讨DSA引导下聚多卡醇泡沫硬化治疗儿童Puig'Ⅰ型和Ⅱ型肛周静脉畸形的临床疗效。

方法

回顾性分析2018年3月至2019年6月就诊于我科的38例Puig'sⅠ型和Ⅱ型肛周静脉畸形患儿，采用全麻下DSA引导经皮多点穿刺3%聚多卡醇泡沫硬化治疗，术后观察疗效、不良反应，术后随访14～28个月。

结果

38例患儿共治疗76次（1～3次/例），治愈28例，基本治愈9例，有效1例；治愈率73.68%（28/38），总有效率为100%。3%聚多卡醇泡沫硬化剂平均单次应用剂量为（5.94±1.69）mL。不良反应：76例次介入硬化治疗术后均有轻度肿胀，3例次肛周静脉畸形皮肤张力性水泡。皮肤轻度溃烂1例，对症治疗10 d后皮肤愈合。

结论

3%聚多卡醇泡沫硬化治疗儿童Puig'sⅠ型和Ⅱ型肛周静脉畸形是一种微创、安全、有效且值得推广的治疗方法。

关键词: 静脉畸形, 儿童, 聚多卡醇, 硬化治疗

Objective

To evaluate the clinical efficacy of DSA-guided sclerotherapy with polidocanol injectable foam in treatment of Puig's Ⅰ and Ⅱ perianal venous malformations in children.

Methods

A retrospective analysis was made of 38 children with Puig's Ⅰ and Ⅱ perianal venous malformations who were treated with DSA-guided percutaneous puncture of 3% polydocarol foam sclerotherapy under general anesthesia from March 2018 to June 2019 in Henan Provincial People's hospital.The curative effect, adverse reactions were observed in follow-up.

Results

The 38 children were treated 76 times (1-3 times/case), and the average single application dose of 3% polydocarol foam sclerosant was (5.94±1.69) mL. 28 cases were cured, 9 cases were basically cured and 1 case was effective; the cure rate was 73.68% (28/38), and the total effective rate was 100%. Adverse reactions. There were mild swelling at the lesion in 76 cases after interventional sclerotherapy and tension blisters in the skin in 3 cases.One patient had mild skin ulceration, however, the ulcertion healed after 10 days of symptomatic treatment. After 14-28 months of follow-up (median follow-up time was 24 months), there was no significant recurrence of symptoms.

Conclusions

3% polydocanol foam sclerotherapy is a minimally invasive, safe, effective and worth popularization treatment for Puig's Ⅰ and Ⅱ perianal venous malformations in children.

Key words: Venous malformation, Children, Polydocanol, Sclerotherapy

图1 经皮穿刺静脉造影示Puig'sⅡ型VM

图2 在路径图模式下注入3%聚多卡醇泡沫硬化剂，清晰显示泡沫硬化剂为负性显影

图3 MRI示肛周皮肤、皮下T2WI高信号

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