儿童血管畸形经股动脉介入治疗

Interventional treatment of vascular malformation in children

目的探讨儿童血管畸形经股动脉介入治疗的方法、疗效及并发症。方法收集2009年1月至2011年6月经介入治疗高流量血管畸形20例，男8例，女12例，年龄4个月14d至14岁7个月，中位年龄4岁5个月，发生于四肢血管畸形最为常见有8例（40％），颈部1例，腋下1例，肩背部3例，腰臀部1例，臀部1例，下肢及会阴1例，肝脏1例，脾脏1例，肾脏2例。治疗方法分别为：①外周血管畸形进行经导管局部灌注硬化剂治疗；②内脏血管畸形进行经导管栓塞术或经导管栓塞加局部灌注硬化剂治疗。结果20例血管畸形患儿介入术后临床症状、体征明显改善，术后2个月至2．5年随访，16例外周血管畸形患儿中8例、5例、3例分别经1、2、3个疗程治疗，显效14例（14／16，87．5％），有效2例（2／16，12．5％），无效0例（O％）；4例内脏血管畸形患儿一个疗程治愈，治愈率100％（4／4）。并发症：16例外周血管畸形患儿介入术后，出现病变部位轻度肿胀不适15例，中度肿胀不适1例，疼痛加剧1例，局部皮温改变1例，病变部位远期感染1例，低热1例；4例内脏血管畸形患儿介入术后，出现一过性轻度肝功能损害和低热1例，短暂性腹痛1例。结论采用经股动脉血管内介入治疗血管畸形是一种微创安全、疗效显著的方法。

Objective To review the efficacy and complications of interventional treatment for vascular malformation in children. Methods Twenty children with vascular malformation （8 males： 12females, age ranged from 0.38 years to 14. 58 years, the median age 4. 42 years） were accepted in this study. Treatment methods contained transcatheter local sclerotherapy, transeatheter embolization and transcatheter embolization combined with local sclerosing agents. Results The extremities were the most commonly affected site （8/20,40 %）. Other locations were cervical region, armpit, shoulder and back, lumbar, gluten[ region, perineum, liver, spleen and kidney. Symptom and physical sign ~m- proved greatly after interventional treatment, from observations done during a follow-up period be- tween 2 months to 2.5 years. In 16 children with peripheral vascular malformation, 8 cases received 1 course of treatment, only 2 courses were given in 5 patients, and 3 courses given in 3 cases. Results were excellent in 14 cases （14/16,87. 5%）, moderately effective in 2 cases （2/16,12. 5%）. In 4 cases with visceral vascular malformation, one course of treatment was enough to cure all （4/4,100%）. Treatment-related complications such as local soft tissue edema and discomfort aggravating pain of the treated area, fever, and short-term liver damage were reported. Conclusions Interventional treatment for vascular malformation in children is mnimally invasive, safe and effective.