射频消融术用于治疗面颈部脉管畸形

Application of radiofrequency ablation in the treatment of cervicofacial vascular malformations

目的:观察射频消融技术治疗面颈部脉管畸形的效果。方法:回顾2009-07～2010-10间32例患者的临床资料。32例患者中16例为静脉畸形1,0例为动静脉畸形,6例为淋巴管畸形。患者接受单纯射频消融治疗或射频消融辅助治疗。通过临床观察、B超、磁共振、三维CT血管造影等评价治疗效果。随访时间3～12个月,平均7个月。结果:16例静脉畸形患者中,14例(87.5%)病变消退率大于90%,2例(12.5%)大于50%。6例口腔黏膜微囊型淋巴管畸形病变消退率均大于90%。10例动静脉畸形患者中,6例(60%)畸形血管基本消退,搏动感消失;4例(40%)畸形血管明显消退,搏动感明显减弱。6例患者出现溃疡、局部组织坏死和瘢痕形成。随访期间未见复发病例。结论:射频消融技术可以有效地治疗或辅助治疗静脉畸形、动静脉畸形和微囊型淋巴管畸形。

Objective： To observe the effects of radiofrequency ablation（RFA） in the treatment of cervicofacial vascular malformations（CVM）.Methods： The clinical data of 32 patients with CVM treated by RFA from July 2009 to October 2010 were reviewed.Of the 32 lesions,16 were venous malformation（VM）,10 arterio-venous malformation（AVM） and 6 lymphantic malformation（LM）.The patients underwent RFA only or RFA-assisted treatment.The outcomes were assessed by physical examination,Doppler ultrasonography,magnetic resonance imaging,and three-dimensional CT angiography.The follow-up time was from 3 months to 1 year after the last treatment（mean,7 months）.Results： Of the 16 VMs,14 lesions（87.5%） showed greater than 90% reduction,whereas another 2（12.5%） exhibited greater than 50% reduction.All of the 6 oral mucosal microcystic LMs showed greater than 90% reduction.Of the 10 AVMs,6（60%） showed that the abnormal vascular lesions almost vanished and the palpable pulse disappeared,whereas another 4（40%） exhibited that the abnormal vascular lesions reduced prominently and the palpable pulse was weakened.The complications included ulceration,local tissue necrosis,and scar formation in 6 patients.There was no recurrence throughout the follow-up period.Conclusion： RFA or RFA-assisted technique is effective for the treatment of VMs,AVMs,and microcystic LMs.