射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化剂灌注治疗口腔颌面部静脉畸形38例疗效评价

Radiofrequency ablation combined with DSA-guided sclerotherapy of polidocanol foam for 38 patients with oral and maxillofacial venous malformation

目的:探讨射频消融联合经皮造影数字DSA引导下聚多卡醇泡沫硬化治疗静脉畸形的疗效。方法:回顾性分析徐州市中心医院2019—2020年收治的38例静脉畸形患者的临床资料。所有患者均接受射频消融联合DSA引导下聚多卡醇泡沫硬化治疗。随访至少6个月,观察并评价疗效。结果:按Puig分型,Ⅰ型20例,Ⅱ型18例。所有患者均行射频消融及DSA引导下聚多卡醇泡沫硬化治疗2~4次。采用Tessari法,按1%聚多卡醇与空气比例1∶3制备泡沫。治愈8例,有效29例,效果不明显1例。治愈率为21.05%(8/38),总有效率为97.37%(37/38)。38例患者经介入硬化治疗后均出现轻度肿胀,3天后肿胀逐渐消退。发生皮肤张力性水疱2例,轻度皮肤溃疡1例,经对症处理后治愈。对症治疗10天后,皮肤愈合过程中未出现过敏反应、异位栓塞、局部或全身感染等严重并发症。随访无复发、窒息、皮肤破裂、瘘管等严重并发症。结论:根据Puig分型,选择射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化治疗口腔颌面部静脉畸形安全有效。

PURPOSE:To investigate the effect of combination of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam in patients with oral and maxillofacial venous malformations.METHODS:The clinical data of 38 patients with venous malformation in Xuzhou Central Hospital from 2019 to 2020 were retrospectively analysed.All patients underwent combined therapy of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam.The curative effect was observed in follow-up of minimum 6 months.RESULTS:The patients were divided into 2 groups according to Puig's classification,type Ⅰ(n=20)and type Ⅱ(n=18).All patients underwent radiofrequency ablation as well as DSA-guided sclerotherapy of polidocanol foam for 2-4 sessions.Polidocanol foam was made by means of Tessari's method with the ratio of 1:3(1%polidocanol vs air).Eight cases were cured,29 cases were basically cured and 1 was less effective.The cure rate was 21.05%(8/38),and the total effective rate was 97.37%(37/38).All 38 cases had mild swelling after sclerotherapy,and the swelling gradually subsided after 3 days.Two cases had skin tension blisters,and 1 case had mild skin ulceration cured after symptomatic treatment.No serious complications such as allergic reaction,ectopia embolism,local or systemic infection occurred.Postoperative follow-up was conducted for 6-12 months.No recurrence,choke,skin rupture,fistula and other serious complications were found.CONCLUSIOINS:According to Puig's classification,it is safe and effective to select combination of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam in patients with oral and maxillofacial venous malformations.