“限流法”在儿童头颈部Puig Ⅲ型静脉畸形治疗中的优势作用

The advantages of "flow restriction method" in the treatment of Puig type Ⅲ venous malformation ofthe head and neck in children

目的 探讨“限流法”在儿童头颈部PuigⅢ型静脉畸形治疗中的安全性和有效性。方法 回顾性分析5例头颈部PuigⅢ型静脉畸形患儿,采用类似肿胀麻醉技术的“限流法”阻断回流静脉,然后进行硬化剂栓塞静脉畸形,随访观察疗效、不良反应和并发症。结果 5例患儿均为PuigⅢ型,均采用“限流法”治疗,共治疗11次。无水乙醇单次注射平均剂量(6.45±0.25) m L,3%聚多卡醇泡沫硬化剂单次注射平均剂量(0.70±0.12) mL。3例治愈,2例基本治愈,有效率为100%。术后随访3~12个月,患儿面容改善满意度100%。结论 对于儿童头颈部PuigⅢ型静脉畸形治疗,“限流法”可显著提高治疗效果,节约患儿的治疗费用。

Objective To investigate the safety and efficacy of“flow restriction method”in the treatment of Puig typeⅢvenous malformations(VM)of the head and neck in children.Methods The clinical data of 5 child patients with Puig typeⅢVM of the head and neck were retrospectively analyzed.The"flow restriction method",which was similar to the swelling anesthesia technique,was used to obstruct the draining vein of the lesion,then,the embolization of VM with sclerosing agent was accomplished.The child patients were followed up to observe the efficacy,adverse effects and complications.Results All the 5 child patients suffered from Puig typeⅢVM of the head and neck and were treated with“flow restriction method”technique.A total of 11 treatments were performed in the 5 child patients.The average dose of single injection of absolute ethanol was(6.45±0.25)mL,and the average dose of single injection of 3%polydocaol foam scleroagent was(0.70±0.12)mL.Three child patients were cured and two child patients were basically cured,with a response rate of 100%.The child patients were follow-up for 3-12 months,the satisfaction with the improvement of facial features was 100%.Conclusion For the treatment of Puig typeⅢVM of the head and neck in child patients,the“flow restriction method”technique can significantly improve the therapeutic effect and save the medical cost.(J Intervent Radiol,2023,32:638-641)