儿童淋巴管畸形44例诊疗分析

The Application of Minimally invasive intervention in treating lymphatic malformations of children

目的：探讨儿童淋巴管畸形的诊疗方法及疗效。方法回顾性分析本院近年来采用数字减影血管造影技术（digital subtraction angiography，DSA）瘤内注射平阳霉素治疗的44例淋巴管畸形患儿临床资料，并进行随访。结果44例患儿均在DSA透视下实施平阳霉素瘤内注射1～7次，治愈14例（32％），显效16例（36％），有效13例（30％），无效1例（2％）。随访6个月至2年，疗效满意，病灶区无瘢痕及色素沉着，术后无明显并发症，总有效率达98％。结论 DSA透视下瘤内注射平阳霉素治疗儿童淋巴管畸形定位准确，损伤小，并发症少，疗效显著，不影响外观和功能，无明显不良反应，对于手术难以切除的淋巴管畸形是一种较好的微创治疗方法。

Objetive To investigate the efficacy and adverse reactions of minimally invasive intervention in treating lymphatic malformations in children. Methods Retrospective analysis was given to the clinical data from 44 cases of lymphatic malformations which was treated with intratumoral injection of bleomycin under DSA （digital subtraction angiography）and fluoroscopy,and followed-up. Results 44 cases of lymphatic malfor-mations of children were treated 1to 7 intratumoral injection of bleomycin that carried out under DSA and fluoroscopy.Followe-up ranged from 6 months to 2 years,14 cases （32%）were cured,16 cases （36%）were markedly effective,13 cases （30%）were effective and 1case （2%）is ineffective.The total effective rates was 98% and no scarring,pigmentation and significant postoperative complications. Conclusion Intratumoral injection of bleomycin carried out under DSA and fluoroscopy is an effective and safe method of treating lymphatic malformations and have the advantages in cluding positioning accuracy,less damage,fewer complications,no affect on appearance,no damage in function and no significant adverse reaction.Especially in treating the complicate lymphatic malformations which is hard to remove by traditional surgery.