供应动脉结扎结合铜丝网状留置治疗肢端动静脉畸形

The ligation of nutrient arteries with a reticular collection of copper wires for the treatment of arteriovenous malformations in the extremities

目的探讨一种治疗肢端动静脉畸形的相对安全有效的方法。方法2003年2月至2006年5月,共收治7例四肢末端动静脉畸形患者,行DSA检查明确动静脉畸形的血供类型。手术结扎或部分切除结扎动静脉畸形的供应动脉,并用直径约0.2mm的铜丝反复穿刺、网状留置于动静脉瘘团中,术后7-9d,拔出铜丝,挤出坏死物质,消毒换药,直至穿刺孔愈合。结果所有患者经治疗后,畸形动脉搏动消失,表面皮肤温度恢复正常。术后早期手术部位水肿,3周后水肿消退,瘤体萎缩,穿刺孔遗留点状瘢痕,基本不影响外观。随访观察6-12个月,未见复发。结论本方法安全有效,是治疗肢端动静脉畸形的较好方法。

Objective To discuss a relatively safe and effective method for the treatment of arteriovenous malfor- mations in the extremities. Methods From February 2003 to May 2006, 7 patients with arteriovenous malformations of the extremities in our department received DSA examination to clarify the type of blood supply of the malformation. The nutrient arteries were ligated or partly excised, and the copper wires of 0.2 mm diameter were used for puncturing through the arteriovenous microfistulas multiple times and these wires were left in situ for 7-9 days. The copper wires were then drawn out, and necrosis secretion was extruded. Wound care with derssing changes was continued until the puncture holes were healed. Results All patients were satisfied with the results. After treatment, the pulse in the nutrient arteries disappeared and the skin temperature over the malformations decreased to a normal level. During the period immediately after treatment, the operative region became edematous but resolved after about 3 weeks. After treatment the arteriovenous malformations collapsed, and only punctiform scars existed at the puncture hole sites, which were of negligible appearance. After 6- 12 months follow up, no recurrence of any arteriovenous malformations was found. Conclusion The ligation of nutrient arteries with a reticular collection of copper wires was an improved method for the treatment of arteriovenous malformations in the extrernities, and was safe and effective.