口腔颌面部静脉血管畸形无水乙醇注射+动力泵平阳霉素灌注的应用研究

Applicaltional study of absolute ethanol injection and pingyangmycin instrallation with dynamic intranidus infusion to treat venous malformation in maxillofacial region

目的 将硬化剂药物无水乙醇与平阳霉素的药物治疗优点相结合,并应用动力泵向瘤腔内灌注药物,为静脉型血管畸形提供新的临床治疗途径。方法 全部病例治疗前先进行瘤腔造影后,根据瘤腔大小注射适量无水乙醇,再次进行造影观察无水乙醇注射后静脉回流血管变化情况后,用动力泵将平阳霉素与生理盐水混合药液缓慢灌注进瘤腔。结果 ①造影片观察显示无水乙醇注射后,静脉畸形瘤腔周围回流静脉明显较注射前变少。②全部病例经1～4次平阳霉素灌注治疗均取得了良好的临床治疗效果。③全部病例术后未出现局部瘤腔感染及其他不良反应。结论 ①无水乙醇对静脉型血管畸形周围回流静脉具有栓塞作用。②应用动力泵灌注平阳霉素+生理盐水混合药液治疗静脉型血管畸形延长了平阳霉素作用时间,并取得了良好的临床治疗效果。

Objective To offer a new way of treatment by using absolute ethanol (AE) injection and pingyangmycin (PYM) dynamic intranidus into venous malformation in maxillfacial region.Methods Angiography was performed in all cases before treatment and suitable dose of AE was injected according to the size of venous malformation.Angiography was used again to observe the change of malformation vessel reflux after injection.Then mixture of PYM and normal saline were slowly infused into tumor.Results ①Angiography showed that outflow of the malformation was decreased after AE injection.②Good results was obtained by one to four times of PYM instrallation in all cases.③Local inflamation and other complications were not present in all cases.Conclusion ①AE has the aibility to obstruct reflux venous around the venous malformation.②Dynamic intranidus PYM and normal saline to treat venous malformation could prolong the function time of PYM and could have good clinical result.