超声引导下介入治疗周围软组织静脉畸形

Sonographically guided intralesional sclerotherapy for venous malformation

目的探讨超声引导下介入治疗周围软组织静脉畸形的有效性和安全性。方法2004年3月至2007年10月收治静脉畸形患者32例，在实时超声引导下视病灶情况（病灶的部位、深浅与重要组织的毗邻关系等）分别选择缓慢推注无水酒精＋博来霉素和单纯博来霉素，3周后若患者未达治愈可重复治疗。患者术后随访6个月-2年。结果所有患者治疗1～6次，平均3次，操作可在门诊进行，不影响工作和生活。治愈27例（84．4％）、好转5例（15．6％）、无效0例。无异位栓塞等严重并发症发生。结论超声引导下介入治疗静脉畸形是一种微创、疗效高、可重复、不良反应少、操作简便的方法。

Objective To investigate the safety and efficacy of sonographically guided percutaneous intralesional sclerotherapy for peripheral venous malformations. Methods From March 2004 to October 2007,32 patients with venous malformations of soft tissues were treated with sonographically guided intralesional sclerotherapy. The malformed venous space was identified intraoperatively by duplex scanning, the gauge 7 needle was inserted into this venous space under real-time ultrasound visualization, and sclerosants were infused in the space gently. Absolute alcohol and bleomycin acted as sclerosants here, combined the two （for type I malformation） or bleomycin only （for type Ⅱ malformation）. The treatment could be repeated if the lesion was not cured in 3 weeks. All patients were followed up for 6 months to 2 years. Results Of the group, each patient received 1-6 times of the therapy（ mean, 3 times）. Twenty-seven patients achieved a complete response, and 5 achieved partial response. No major complications occurred. Conclusions Sonographieally guided percutaneous intralesional sclerotherapy for peripheral venous malformation is a simple, effective, safe therapy with minimal invasion, lower morbidity rate, and can be repeated.