瘤体穿刺置管注射尿素治疗海绵状血管瘤

Intralesional urea injection by a IV catheter placement for treatment of cavernous haemangioma

目的:总结瘤体穿刺置管治疗海绵状血管瘤的疗效。方法:海绵状血管瘤患者23例,其中男13例,女10例,年龄3～22岁,血管瘤位于头面部的5例、四肢16例、躯干部2例。采用静脉留置针直接穿刺瘤体中心部位并妥善固定,然后根据瘤体造影确定的血流动力学特征(低回流量型或高回流量型),对于低回流量型每日经留置针直接注入40%尿素溶液5～15ml,而对于高回流量型,注射前暂时性阻断其回流静脉,然后采用上述方法注射治疗,直至瘤体变硬、萎缩。并与既往类似病变,采用一般局部注射及动脉插管注射尿素的血管瘤患者各20例进行比较。结果:瘤体穿刺置管治疗组治愈、好转率明显高于动脉局部注射治疗组和动脉插管注射治疗组(P<0.05),瘤体穿刺置管治疗组疗程明显短于尿素局部注射治疗组和动脉插管注射治疗组(P<0.05),且并发症发生率显著低于尿素局部注射治疗组和动脉插管注射治疗组(P<0.05)。结论:瘤体穿刺置管注射尿素治疗海绵状血管瘤操作简便、疗程短、疗效好、并发症少且经济,值得临床推广。

Objective To improve urea therapy for cavernous haemangioma（CH）. Methods 23 patients with CH were studied in our department from Jan, 2003 to Jul, 2005. 13 ones were male and 10 were female, and 5 with CH on head, 16 on limbs and 2 on trunk. A IV （intravenous） catheter was directly pricked into the central area of CH and fixed with its wings on skin, then radiological examination was carried out to decide the lesion＇s haemodynamics （high flow or low flow） by contrast injection through the catheter. Then,for low flow type,5 to 15ml 40% urea solution was administered also through the catheter daily,but for high flow type, the lesion＇s drain veins were temporally obliterated, and urea was administered in the same way,until the lesion become hard or shrink back. The common urea local injection group and arterial catheterization injection group were compared. Results The healing rate was higher than those both in common urea local injection group and arterial catheterization injection group （respectively,P〈0.05）;The average time of treatment was also shorter than those in orther two groups （respectively,P〈0.05）;The complication rate of this was also less than those in orther two groups（respectively,P〈0.05）. Conclusion Intralesional urea injection by IV catheter placement is an effective method for CH with higher healing rate, less treatment time and less complication rate, furthermore it is economic, convenient, easy to grasp.