纵向缩缝加血管包裹法治疗小儿颈内静脉扩张症

Longitudinal Constriction Venoplasty Plus Encapsulation Applied to Treat Internal Jugular Phlebectasia in Children

目的总结采用纵向缩缝加血管包裹法治疗小儿颈内静脉扩张症的疗效。方法回顾性分析1999年7月￣2006年5月我院收治的14例小儿颈内静脉扩张症的临床资料。右侧9例,左侧2例,双侧3例。均于病变血管阻断后,纵向缩缝使其缩至正常血管口径,再用涤纶布片或人工血管补片进行血管包裹加固。结果14例患儿均痊愈出院,平均随访3个月￣6年,未见复发。结论纵向缩缝加血管包裹法治疗小儿颈内静脉扩张症,血流动力学不受影响,并发症少。

Objective To evaluate the efficacy of longitudinal constriction venoplasty plus encapsulation （LCVE） to treat the internal jugular phlebectasia （IJP） in children. Methods 14 cases of IJP between July 1999 and May 2006 in-patient in our hospital were reviewed. B-ultrasound or color Doppler flow imaging （CDFI）of all the children were performed, and combination with the Valsalva＇s breathing test. After bloking pathologic blood vessel, surgical intervention was first of longitudinal constriction suture venoplasty, the vessel caliber was reduced to normal, then the vessel was encapsulated and fixed with medical Dacron cloth or PTFE artificial vessel patch. Results B-ultrasound or CDFI demonstrated local dilatation of internal jugular veins in all patients. Surgical intervention confirmed the internal jugular veins were involved on right side in 9 cases, left side in 2 cases and bilateral in 3 cases. All of the children were discharged with healing, and were followed up for 3 months to 6 years without recurrence. Conclusions B-ultrasound or CDFI, or in combination with the Valsalva＇s breathing test, was the diagnostic procedure of choice for IJP. LCVE might be more preferable and physiological, and should be recommended for IJP.