儿童头颈部血管畸形栓塞剂的选择与应用

The Embolism Material Selection and Application of Children's Vascular Malformations in Head and Neck

目的探讨儿童头颈部血管畸形介入治疗栓塞剂的选择与应用。资料与方法对33例栓塞治疗患儿所选用的血管内栓塞材料,结合栓塞术后远期疗效予以总结。33例中,血管畸形发生于头面部24例,颈肩部9例。栓塞术中采用动脉选择或超选择性插管技术,向靶血管内分别释放的栓塞材料为:(1)弹簧圈;(2)弹簧圈、明胶海绵颗粒、硬化剂组合;(3)明胶海绵颗粒、条、硬化剂组合;(4)明胶海绵条、硬化剂组合等实施动静脉瘘、畸形血管网和导入动脉的栓塞。结果29例(88%)患儿通过栓塞治疗获痊愈,经1～5年追踪随访疗效稳定,4例(12%)经2年以上随访观察栓塞治疗有效。结论针对儿童头颈部血管畸形,应用弹簧圈+明胶海颗粒+硬化剂;明胶海绵颗粒+条+硬化剂;明胶海绵条+硬化剂等组合栓塞剂,实施栓塞治疗均能获得持久而稳定的疗效。

Objective To discuss the embolism material selection and application of children＇ s vascular malformation in head and neck. Materials and Methods Embolism material selection with clinical effect in 33 patients was summarized. Head and face vascular malformations were occurred in 24 children, 9 children with neck and shoulder vascular malformations. Selection or superselection artery catheter technique was used. Embolism materials included： （ 1 ） Steel wire collar; （2）Steel wire collar, absorbable gelatin sponge and hardener assembly;（ 3 ） Absorbable gelatin sponge bar, granule and hardener assembly; （4） Absorbable gelatin sponge bar and hardener assembly. Results 29 （ 88% ） cases were recovered by embohsm therapy, therapeutic effectiveness was stable after 1 - 5 years. 4（ 12% ） cases were effective in observation of 2 years. Conclusion Applications of combining with various embolism material is effective to children＇ s vascular malformation in head and neck.