聚桂醇泡沫硬化剂治疗静脉畸形效果与安全性评价

Lauromacrogol foam sclerotherapy for the treatment of venous malformations: evaluation of its curative effect and safety

目的评价聚桂醇泡沫硬化剂治疗静脉畸形的效果及安全性。方法收集2013年6月至2015年8月采用聚桂醇泡沫硬化剂治疗的35例静脉畸形患者临床资料。其中病变位于头颈部31例,四肢及其它部位4例;根据回流静脉特点分为4型;根据对比剂回流速度分为低回流型和高回流型。DSA导引下每4周注射1次聚桂醇泡沫硬化剂,末次治疗后随访6个月,评价主、客观疗效,记录不良反应。结果 35例患者中Ⅰ型8例,Ⅱ型20例,Ⅲ型5例,Ⅳ型2例;低回流型25例,高回流型10例。35例共接受66次泡沫硬化剂治疗,每例平均2.2次;平均单次应用硬化剂12(8～50)mL。术后1～3 d患者有局部肿胀、疼痛,无皮肤、肌肉及神经损伤等严重并发症。末次随访显示主观疗效有效率在低回流型患者为25/25,高回流型患者为7/10(P<0.01);客观疗效有效率在低回流型患者为25/25,高回流型患者为7/10(P<0.01)。结论聚桂醇泡沫硬化剂治疗静脉畸形效果肯定,对低回流型疗效更为显著,无严重并发症发生。

Objective To evaluate the curative effect and safety of lauromacrogol foam sclerotherapy in treating venous malformations. Methods The chnical data of 35 patients with venous malformations, who were admitted to authors＂ hospital during the period from June 2013 to August 2015 to receive lauromacrogol foam sclerotherapy, were retrospectively analyzed. The lesions were located at cephalocervical region in 31 patients and at limbs or other parts of the body in 4 patients. According to the characteristics of draining vein, the malformations were classified into 4 types; and based on the velocity of contrast flowing, the malformations were divided into low-flow type and high-flow type. Under DSA guidance, the injection of lauromacrogol foam hardening agent was performed once every 4 weeks. The patients were followed up for 6months after the last injection, the curative effect was evaluated both subjectively and objectively, and the adverse reactions were recorded. Results Of the 35 patients, type Ⅰ was seen in 8, type Ⅱ in 20, type Ⅲ in 5 and type 1V in 2. Twenty-five patients belonged to low-flow type, and 10 patients belonged to high-flow type. A total of 66 times of foam sclerotherapy therapy were carried out in 35 patients, with a mean of 2.2 times for each patient. The average dosage of hardening agent for a single procedure was 12 mL （8-50 mL）. In 1-3 days after the treatment, patients developed local swelling and pain, but no severe complications, such as injuries of skin, muscle and nerve, occurred. Last follow-up examination indicated that subjective effective rates in the low-flow type group and in the high-flow type group were 100% （25/25） and 70% （7/ 10） respectively, and the objective effective rates in the low-flow type group and in the high-flow type group were also 100% （25/25） and 70% （7/10） respectively; the differences in both subjective and objective effective rate between the two groups were statistically significant （P〈O.O1）. Conclusion For the treatment of venous malformations, lauromaerogol foam sclerotherapy has definite effect, and the curative effect is more remarkable for the venous malformations of low-flow type, besides, this therapy has no severe complications.