查看更多>>摘要：目的 探讨血管瘤和脉管畸形患者日间硬化剂治疗的效果及安全性。 方法 回顾性分析2021年5月至2022年1月中南大学湘雅二医院血管外科日间病房收治的132例血管瘤和脉管畸形患者的临床资料，其中男性55例，女性77例；血管瘤36例，静脉畸形78例，动静脉畸形7例，淋巴管畸形2例，毛细血管畸形4例，其他5例。比较分析不同病变类型患者的一般资料、治疗情况和并发症情况。 结果 132例患者中，总计完成注射275次，每人（2.1±1.4）次（范围：1~9次）。1%聚多卡醇注射液用量176支，3%用量111支，单次注射（5.3±3.4）ml。直接注射185次，单次注射聚多卡醇泡沫（4.0±2.8）ml；超声引导下注射90次，单次注射（7.9±3.2）ml；两种注射方式下注射剂量的差异有统计学意义（t=10.05，P<0.001）。1%聚多卡醇使用171次，单次注射（4.2±2.9）ml，3%聚多卡醇使用104次，平均单次注射（6.8±3.6）ml；两种浓度单次注射剂量的差异有统计学意义（t=6.938，P<0.001）。总有效率92.5%（122/132），包括治愈率37.2%（49/132），好转率55.3%（73/132），无效率3.0%（4/132），4.5%（6/132）的患者无法评估疗效。血管瘤、静脉畸形、动静脉畸形和淋巴管畸形治疗有效率分别为97.2%（35/36）、93.6%（73/78）、100%（7/7）和100%（2/2）。13例患者出现并发症，其中动静脉畸形并发症发生率为42.9%（3/7）。 结论 血管瘤、静脉畸形和淋巴管畸形的泡沫硬化剂治疗有效率高，在超声引导下进行日间治疗安全可行。 Objective To study the effectiveness and safety of day therapy of sclerotherapy (ST) on patients with hemangioma and vascular malformation. Methods Clinical data of 132 patients with hemangioma and vascular malformation on the day ward of the Department of Vascular Surgery, The Second Xiangya Hospital of Central South University between May 2021 and January 2022 were retrospectively analyzed, including 55 males and 77 females. There were 36 cases of hemangioma, 78 cases of venous malformation, 7 cases of arteriovenous malformation, 2 cases of lymphatic malformation, 4 cases of capillary malformation, and 5 others. The general information, treatment condition, and complications of different lesion types were summarized. Results A total of 275 injections were finished among the 132 patients, with (2.1±1.4) injections per person. The number of single treatments was 1-9 times. The 1% polidocanol (POL) dosage for injection was 176 pieces, and 3% POL was 111 pieces with single injection of (5.3±3.4) ml. There were 185 times of direct injection, and single injection of POL foam was (4.0±2.8) ml 90 times of ultrasound-guided injection, and single injection was (7.9±3.2) ml. The difference in injection dose between the two injection methods was statistically significant. (t=10.05, P<0.001). 1% POL was used 171 times while 3% POL 104 times, with single injection was (4.2±2.9) ml and (6.8±3.6) ml, respectively. The difference between the two concentrations of a single injection dose was statistically significant (t=6.938, P<0.001). The total effective rate was 92.5% (122/132), including 37.2%(49/132) of cure rate and 55.3%(73/132) of improvement rate, the ineffective rate was 3.0%(4/132) and the therapeutic effects of the remaining 4.5%(6/132) of patients can't be evaluated. The effective rate in patients with hemangioma, venous malformation, arteriovenous malformation, and lymphatic malformation was 97.2%(35/36), 93.6%(73/78), 100%(7/7) and 100%(2/2), respectively. Complications occurred in 13 patients (9.8%), of which the incidence of arteriovenous malformation was 42.9%(3/7). Conclusion ST is effective in treating hemangioma, venous malformation, and lymphatic malformation. It is safe and feasible to perform day therapy under the guidance of ultrasound.
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