尿素注射联合手术切除治疗咬肌区静脉畸形的疗效

Effect of urea injection combined with operation resection treatment on venous malformation in the masseteric region

目的探讨尿素注射联合手术切除治疗咬肌区静脉畸形的疗效及安全性。方法选取磁共振上显示瘤体边界清晰的咬肌区静脉畸形患者56例,采用尿素局部注射联合手术治疗,尿素注射2~5 mL,每日1次,7 d为1个疗程。尿素治疗结束后2~3 d行手术切除,术后评估瘤体缩小情况以及面神经安全性,并追踪随访,评价疗效。结果56例患者随访2~72个月,平均随访（44.5±2.0）个月。54例（96.4%）手术一期成功,未见复发,经Burres-Fisch面神经评定系统评估为100分;2例术后出现并发症,经对症治疗,6个月后Burres-Fisch面神经评分系统评估为100分。结论手术是治疗静脉畸形的有效方法;术前尿素注射可硬化瘤体,减少术中出血,咬肌区静脉畸形瘤体边界清晰的患者应考虑尿素瘤内注射联合手术切除。

Objective To evaluate the efficacy and safety of urea injection combined with operation management on venous malformation in masseter muscle area. Methods Fifty-six patients with venous malformation in masseter muscle area whose tumor had clear boundary on magnetic resonance imaging were selected and treated with the urea injection combined with operation. Urea was injected once a day for continuous seven days. Two to three days after the urea injection, operation was followed. The tumor volume and facial nerve salty were evaluated and the curative effect was evaluated though following up. Resuits Fifty-six patients were followed up for 2 - 72 months, and the mean follow-up time was （44.5 ± 2.0） months. Operative incision of 54 cases（96.4% ） were successful. No case developed recurrence. Assessed with Burres-Fisch facial nerve scoring system ,54 eases（96.4% ） had a score of 10〈3 points. Two eases had complications. But after six months, they had a score of 100 point after symptomatic treatment. Conclusions The operation is still the main effective method to treat venous malforma- tion. Preoperative urea injection can make it hardened, decreasing bleeding during the operation, and the tumor boundary of the tumor is more clear. Because of the particularity of the venous malformation of masseteric region, the tumor with clear boundary should be treated with the urea injection combined with operation.