聚多卡醇经皮硬化治疗成人巨大唇颊部微静脉畸形

Polydocanol percutaneous sclerotherapy for the treatment of giant venular malformation of the lips and cheeks in adults

目的探讨聚多卡醇硬化治疗成人巨大唇颊部微静脉畸形的临床疗效。方法 2019年9月至2020年9月在徐州市中心医院就诊,临床诊断为巨大唇颊部微静脉畸形的5例患者。使用聚多卡醇泡沫硬化剂瘤体内注射治疗,注射3周后复诊,对于临床症状未缓解,MRI检查示病灶残留> 25%,或症状稳定后再次复发,则需再次治疗。治疗终点为:(1)临床症状消退且MRI检查显示病灶残留<25%;(2)连续治疗4次症状无缓解或加重者;(3)放弃治疗者。结果 5例患者完成全程治疗,注射治疗次数为2~4次,参照Achauer标准评价疗效,达Ⅰ级疗效者1例,Ⅱ级疗效者2例,Ⅲ级疗效者2例。其中1例患者术前病灶出现糜烂出血,术后症状得到明显改善。1例患者术后病灶处出现色素沉着,其它无明显严重不良反应。结论聚多卡醇泡沫硬化剂局部注射治疗成人巨大唇颊部微静脉畸形是一种安全有效治疗方法,且对自发性出血的微静脉畸形有一定的止血作用。

Objective To investigate the clinical effect of polidocanol sclerotherapy in the treatment of giant venular malformations of the lips and cheeks in adults.MethodsFrom September 2019 to September 2020,5 patients with huge venular malformations of the lips and cheeks(4 males,1 female)admitted to Xuzhou Central Hospital were included in the study.All the patients were treated with local injection of polidocanol foam scleroagent,and all patients were followed up with a 3-week treatment course.If the clinical symptoms were not alleviated and the MRI examination showed that>25%of the lesion remained,or it relapsed again after symptoms are stable,the patient needed to be treated again.The endpoints of treatment were:(1)subsidence of clinical symptoms and MRI showing residual lesions<25%in size;(2)continuous treatment for 4 times without relief or aggravation of symptoms;(3)a discontinuation of treatment.ResultsAll 5 patients successfully completed the treatment and were injected 2 to 4 times during treatment.The curative effect was evaluated according to the Achauer standard,including gradeⅠcurative effects in 1 patient,gradeⅡin2 patients,gradeⅢin 2 patients.Among them,one patient suffered from erosion and bleeding in the lesion before the operation,and the symptoms were significantly improved postoperatively.No serious side effects were found except skin pigmentation in 1 case.Conclusion Local injection of polidocanol foam scleroagent is a safe and effective treatment method for adult giant venular malformations of the lips and cheeks,and it has a hemostatic effect on spontaneous bleeding invenular malformations.