聚多卡醇泡沫硬化治疗儿童Puig'sⅠ型和Ⅱ型肛周静脉畸形临床研究

Clinical study on sclerotherapy with polidocanol injectable foam in treatment of Puig'sⅠandⅡperianal venous malformations in children

目的探讨DSA引导下聚多卡醇泡沫硬化治疗儿童Puig'Ⅰ型和Ⅱ型肛周静脉畸形的临床疗效。方法回顾性分析2018年3月至2019年6月就诊于我科的38例Puig'sⅠ型和Ⅱ型肛周静脉畸形患儿,采用全麻下DSA引导经皮多点穿刺3%聚多卡醇泡沫硬化治疗,术后观察疗效、不良反应,术后随访14~28个月。结果38例患儿共治疗76次(1~3次/例),治愈28例,基本治愈9例,有效1例;治愈率73.68%(28/38),总有效率为100%。3%聚多卡醇泡沫硬化剂平均单次应用剂量为(5.94±1.69)mL。不良反应:76例次介入硬化治疗术后均有轻度肿胀,3例次肛周静脉畸形皮肤张力性水泡。皮肤轻度溃烂1例,对症治疗10 d后皮肤愈合。结论3%聚多卡醇泡沫硬化治疗儿童Puig'sⅠ型和Ⅱ型肛周静脉畸形是一种微创、安全、有效且值得推广的治疗方法。

Objective To evaluate the clinical efficacy of DSA-guided sclerotherapy with polidocanol injectable foam in treatment of Puig'sⅠandⅡperianal venous malformations in children.Methods A retrospective analysis was made of 38 children with Puig'sⅠandⅡperianal venous malformations who were treated with DSA-guided percutaneous puncture of 3%polydocarol foam sclerotherapy under general anesthesia from March 2018 to June 2019 in Henan Provincial People's hospital.The curative effect,adverse reactions were observed in follow-up.Results The 38 children were treated 76 times(1-3 times/case),and the average single application dose of 3%polydocarol foam sclerosant was(5.94±1.69)mL.28 cases were cured,9 cases were basically cured and 1 case was effective;the cure rate was 73.68%(28/38),and the total effective rate was 100%.Adverse reactions.There were mild swelling at the lesion in 76 cases after interventional sclerotherapy and tension blisters in the skin in 3 cases.One patient had mild skin ulceration,however,the ulcertion healed after 10 days of symptomatic treatment.After 14-28 months of follow-up(median follow-up time was 24 months),there was no significant recurrence of symptoms.Conclusions 3%polydocanol foam sclerotherapy is a minimally invasive,safe,effective and worth popularization treatment for Puig'sⅠandⅡperianal venous malformations in children.