摘要
目的 探讨数字减影血管造影(DSA)引导下经皮泡沫硬化剂联合博来霉素硬化治疗儿童舌Puig Ⅲ型静脉畸形的临床效果和安全性.方法 回顾性分析2021年1月-2022年12月徐州市儿童医院采用经皮注射硬化治疗的9例舌部Puig Ⅲ型静脉畸形患儿临床资料.其中男5例,女4例.根据术前MRI检查确定静脉畸形范围,DSA下确定静脉畸形分型、大小及引流静脉情况,在DSA监视下行硬化注射治疗.术后1个月行MRI磁共振成像复查,如果发现有残留病灶,则继续进行硬化治疗.每次记录病灶大小及不良反应,随访评价疗效.结果 9例患儿共进行了 22次硬化治疗,平均每例接受治疗次数为(2.5±1.0)次.随访12个月,6例治愈,2例症状明显缓解,1例部分缓解,所有病例均无复发或进展.出现局部张力性水泡后破溃1例.结论 泡沫硬化剂联合博来霉素硬化治疗儿童舌Puig Ⅲ型静脉畸形安全有效,不影响舌外观及功能,并发症少.
Abstract
Objective To explore the clinical efficacy and safety of digital subtraction angiography(DS A)-guided percutaneous foam sclerosant combined with bleomycin sclerotherapy in the treatment of pediatric Puig Ⅲ venous malformation of the tongue.Methods The clinical data of 9 children(5 boys and 4 girls)with Puig type Ⅲ venous malformation of the tongue treated with percutaneous injection sclerotherapy in our hospital from January 2021 to December 2022 were retrospectively analyzed.The size of venous malformation on preoperative MRI as well as the classification,size,and draining veins of venous malformations on DS A were determined.Percutaneous sclerotherapy under DS A fluoroscopy was performed and continued if residual lesions were displayed on 1-month follow-up MRI.The size of the lesion and adverse reactions were recorded.Results Nine patients received a total of 22 sclerotherapy treatments with an average of(2.5±1.0)treatments per case.At 12-month follow-up,6 children were cured,2 showed significant symptom relief,1 partially relieved,and 1 had lesion rupture after the appearance of local tension blisters.There was no recurrence or progression in any patient.Conclusion Foam sclerosant combined with bleomycin sclerotherapy is safe and effective in the treatment of pediatric Puig Ⅲ venous malformation without affecting the appearance and function of the tongue,and with fewer complications.
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