常用硬化剂治疗静脉畸形导致神经损伤的回顾性研究

Retrospective Analysis of Neuropathy Following Sclerotherapy for Treating Venous Malformations

目的：探索临床常用硬化剂无水乙醇和聚桂醇在治疗静脉畸形过程中与神经损伤发生的相关性。方法自2014年1月至2015年3月，以单次治疗中的硬化剂类型为分组依据，将436例静脉畸形患者分为无水乙醇治疗组和聚桂醇治疗组。比较两种硬化剂的治疗完成率和临床有效率，并分析治疗导致的神经损伤的相关情况。结果无水乙醇组成功率为98.1%，治疗有效率为94.7%；治疗期间11例患者出现了12次的神经损伤症状；随访3-12个月，所有损伤患者中7例恢复，2例部分恢复，2例未恢复。聚桂醇组硬化操功率为98.3%，治疗有效率88.4%，1例患者出现注射后相关区域麻木，2周后自行恢复。结论静脉畸形治疗中无水乙醇和1%聚桂醇注射液在治疗静脉畸形时都具有良好的有效性和安全性，但无水乙醇注射更易引起神经损害的发生。

Objective To evaluate the risk of neuropathy following sclerotherapy for treating venous deformities with absolute ethanol and lauromacrogol. Methods From January 2014 to March 2015, 436 VM patients were treated by absolute ethanol and lauromacrogol and divided into two groups. Technical and clinical success of included procedures was evaluated, while complications were reviewed with a particular focus on nerve injury. Results In absolute ethanol group, operating successful rate was 98.1%, and effective rate was 94.7%. Symptoms of nerve injury were observed in 11 patients （12 lesions）. After followed up for 3-12 months, neuropathy symptoms resolved completely in 7 patients, 2 patients recovered partially, and 2 patients recovered without obvious improvement. In lauromacrogol group, operating successful rate was 98.3%, and effective rate was 88.4%. Injection related numbness was observed in 1 patient and recovered automatically after 2 weeks. Conclusion Both absolute ethanol and lauromacrogol have good efficacy and safety in treating venous deformities, but absolute ethanol injection is more likely to cause nerve damage.