手术联合Nd：YAG激光治疗眼周弥漫性海绵状血管畸形

Surgical procedure combined with Nd:YAG laser irradiation for management of diffuse cavernous vascular malformation in peri-orbital regions

目的评价手术联合Nd:YAG激光治疗眼周弥漫性海绵状血管畸形的有效性和安全性。方法自2003年1月至2006年5月共收治眼周弥漫性海绵状血管畸形患者14例,其中4例为手术后复发病例。年龄11～44岁;病程10个月～35a。均采用手术翻瓣联合Nd:YAG激光治疗的方法:先以外科手术翻瓣暴露静脉畸形病灶,术中应用连续Nd:YAG激光照射凝固瘤体病灶,然后切除缩小的瘤体组织,直接缝合创面。对于结膜下瘤体组织可直接照射,但须用棉片保护角膜。结果14例患者术后无眼睑及眼球运动功能障碍或切口大出血等并发症,经随访2～40个月,未见复发。结论手术联合Nd:YAG激光治疗眼周弥漫性海绵状血管畸形具有操作简便、组织损伤小、出血少、疗效确切、并发症少等优点,为弥漫性海绵状血管畸形的治疗提供了新途径。

Objective To evaluate the effectivity and safety of the method of surgical procedure combined with Nd：YAG laser irradiation for the management of diffuse cavernous vascular malformation in peri-orbital regions. Methods From January,2003 to May,2006,14 cases of diffuse cavernous vascular malformations in peri-orbital regions were treated by continuous wave Nd：YAG laser irradiation after surgical flap raising. Four cases were recurred after surgery. The age was diversed from 11 to 44, and the course of disease was from 10 months to 35 years. Contractible tumor was removed and raw surface was sutured. Direct irradiation was taken for subconjunctival vascular malformations, but the cornea should be protected. Results Follow up from 2 to 40 months,all the 14 cases had no complications about losing motion in eyelid and eyeball and bleeding in incision. Conclusion Because of simple manipulation and little damage and bleeding, fewer complications and higher successful rate, surgical procedure combined with Nd ：YAG laser irradiation has been proved to be a valuable means of treating diffuse cavernous vascular malformations.