纤维蛋白胶复合平阳霉素栓塞硬化治疗面颈部静脉畸形的远期疗效观察

Long term observation of using fibrin glue combined with pingyangmycin for embolization and sclerotherapy of cervicofacial venous malformation

目的:评价纤维蛋白胶复合平阳霉素栓塞硬化治疗面颈部静脉畸形的临床效果。方法:回顾2005年1月—2012年1月应用纤维蛋白胶复合平阳霉素栓塞硬化技术治疗的78例面颈部静脉畸形患者资料。63例患者接受纤维蛋白胶/平阳霉素栓塞硬化+平阳霉素注射治疗,15例患者除上述治疗外,还接受了无水乙醇硬化、射频消融或手术治疗。治疗后观察患者生命体征及症状,拍摄胸片了解肺部情况。通过临床观察、B超、MRI检查评价治疗效果。随访时间6个月～7 a。结果:78例患者中,男41例,女37例;年龄10岁～66岁(平均26岁)。67例(85.9%)病变消退率大于90%,11例(14.1%)大于50%。6例患者出现高热,未发现过敏反应、肺栓塞或其他并发症。结论:纤维蛋白胶/平阳霉素栓塞硬化技术安全、有效,并发症在可接受范围,适用于治疗大范围、高回流静脉畸形。

PURPOSE： To evaluate the outcome of fibrin glue （FG） combined with pingyangmycin for the treatment of cervicofacial venous malformation （VM）. METHODS： The data of 78 cases with VM from January 2005 to January 2012 was reviewed. Of the 78 cases, 63 underwent embolization and sclerotherapy of FG combined with pingyangmycin, and subsequent injection of pingyangmycin only; 15 underwent injection of ethanol, radiofrequency ablation, or surgical resection besides embolization and sclerotherapy of FG combined with pingyangmycin. The vital signs and symptoms after treatments were observed. Chest X-ray film was taken for evaluation of pulmonary status. The therapeutic effect was evaluated by clinical examination, ultrasonography with Doppler, or magnetic resonance imaging （MRI）. The follow-up time was from 6 months to 7 years. RESULTS： Of the 78 patients, 41 were male and 37 were female, ranging in age from 10 to 66 years （mean, 26 years）. Sixty seven of 78 lesions （85.9%） showed greater than 90% reduction, whereas another 11 （14.1%） exhibited greater than 50% reduction. Six patients had fever. There was no allergic reaction, pulmonary embolization or other complications after treatment. CONCLUSION： Embolization and sclerotherapy of FG combined with pingyangmycin for cervicofacial VMs was safe and effective. The complications are acceptable. It was a promising therapeutic method for larger and rapid draining VMs.