经皮无水乙醇栓塞治疗儿童足部动静脉畸形11例

Percutaneous ethanol embolization for the treatment of arteriovenous malformation of foot in children:preliminary results of 11 cases

目的评价经皮无水乙醇栓塞术(PEE)治疗儿童足部动静脉畸形(AVM)的安全性及疗效。方法回顾性分析2007年1月至2016年1月经PEE术治疗的11例儿童足部AVM患者临床资料,评估临床症状、瘤巢分型、疗效及术后并发症。结果 11例患儿中男6例,女5例,平均年龄9岁;足部肿物8例,疼痛8例,跛行3例,皮肤缺血溃疡1例;ChoⅢb型10例,Ⅱ型1例;YakesⅣ型10例,Ⅱa型1例。共接受PEE治疗30次,平均2.7次/例;随访6~48个月,平均24个月。疗效评价显示,治愈7例,部分缓解3例,有效率为90.9%;治疗失败(无缓解)1例,无恶化患儿;术中发生一过性血氧下降1例,足趾缺血1例,术后水疱1例,局部皮肤溃疡1例,未见严重并发症。结论 PEE术是治疗儿童足部AVM安全有效的方法。

Objective To evaluate the safety and efficacy of percutaneous ethanol embolization （PEE） in treating arteriovenous malformation （AVM） of foot in children. Methods The clinical data of 11 sick children with arteriovenous malformation of foot, who were treated with PEE in authors＇ department during the period from January 2007 to January 2016, were retrospectively analyzed. The clinical symptoms, the type of tumor nidus, the therapeutic effect and the postoperative complications were analyzed. Results The 11 sick children included 6 boys and 5 girls, with a mean age of 9 years. Foot mass was seen in 8 children, pain in 8 children, claudication in 3 children and ischemic skin ulcer in one child. Cho Ⅲ b type was observed in 10 children and Cho Ⅱ type in one child; Yakes IV type was found in 10 children and IIa type in one child. A total of 30 PEE procedures were performed, with an average of 2.7 times per case. The children were followed up for 6-48 months, with a mean of 24 months. Evaluation of curative effect showed that complete cure was achieved in 7 children and partial remission in 3 children, the effective rate was 90.9%. Treatment failure（showing no remission） was seen in one child, and no deterioration of disease was observed. Complications included transient blood oxygen decrease in operation （n=1）, toe ischemia （n=1）, postoperative blister （n=l） and local skin ulcer （n=1）, no severe complications were observed. Conclusion PEE is a safe and effective treatment for arteriovenous malformation of foot in children. （J Intervent Radiol, 2017, 26： 394- 398）