经皮射频热凝术治疗指端甲下血管球瘤的效果

Effect of percutaneous radiofrequency thermocoagulation in the treatment of fingertip subnail glomus tumor

目的探讨经皮射频热凝术治疗指端甲下血管球瘤的有效性和安全性。方法选择2018年10月至2021年5月在南京大学医学院附属鼓楼医院疼痛科门诊就诊的指端甲下血管球瘤患者7例,将其按行手术的时间顺序编号(1~7号)。所有患者均行超声引导下经皮射频热凝术,并于术后完成随访(≥6个月),观察术前及术后6个月时患者视觉模拟评分法(VAS)评分变化,记录患指外观、冷敏感试验及Love试验情况。结果1号患者治疗时出现皮肤烫伤,术后2个月痊愈,为防止此情况,使用生理盐水对手术进行了改良,2~7号患者治疗过程中未见明显不良反应。所有患者术后6个月的VAS评分均高于术前,差异有统计学意义(P<0.05)。所有患者术后6个月时冷敏感试验结果均为阴性。4号患者术后6个月时Love试验结果可疑,其余患者Love试验结果均为阴性。4号患者术后12个月时疼痛复现,后经外科手术切除瘤体后疼痛完全缓解。所有患者术后6个月时患指皮肤及甲床均无损伤,患指外观正常。结论经皮射频热凝术治疗指端甲下血管球瘤,操作方便,可有效缓解疼痛,且无甲床损伤或术后畸形等并发症,可作为手术切除以外的一种补充治疗方法。

Objective To investigate the efficacy and safety of percutaneous radiofrequency thermocoagulation in the treatment of fingertip subnail glomus tumor.Methods A total of seven patients with fingertip subnail glomus tumor admitted to the Outpatient of Department of Pain Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical College from October 2018 to May 2021 were selected and numbered in chronological order(No.1-7).All patients underwent ultrason-guided percutaneous radiofrequency thermocoagulation,and follow-up was completed after surgery(≥six months).Changes of visual analog scale(VAS)score were observed before and six months after surgery,and the appearance of the affected finger,cold sensitivity test,and Love test were recorded.Results No.1 patient developed skin scald during treatment and recovered two months after surgery.In order to prevent this situation,the operation was modified with normal saline,and no obvious adverse reactions were observed during the treatment of No.2-7 patients.VAS scores of all patients six months after surgery were higher than those before surgery,the difference was statistically significant(P<0.05).Cold sensitivity test results were negative in all patients six months after surgery.The Love test results of No.4 patient were suspicious six months after surgery,the results of other patients were negative.The pain of No.4 patient recurred 12 months after surgery,and the pain was completely relieved after surgical resection of the tumor.All patients had no damage to the skin and nail bed of the affected finger six months after surgery,and the appearance of the affected finger was normal.Conclusion Percutaneous radiofrequency thermocoagulation in the treatment of subungual glomus tumor of fingertips is easy to operate,which can effectively relieve pain,and has no complications such as nail bed injury or postoperative deformity.It can be used as a supplementary treatment in addition to surgical resection.