B超引导下1470 nm激光联合聚桂醇硬化剂注射治疗周围动静脉畸形的疗效分析

Efficacy Analysis of Ultrasound-guided 1470 nm Intracavitary Laser Combined with Lauromacrogol Foam in the Treatment of Peripheral Arteriovenous Malformations

目的:探讨B超引导下1470 nm激光联合聚桂醇硬化剂注射治疗周围动静脉畸形的疗效。方法:选择2019年1月-2024年2月笔者科室收治并确诊为周围动静脉畸形的81例患者,按周围动静脉畸形影像学类型特征,将患者分为三组(其中Ⅰ型组14例,Ⅱ型组30例,Ⅲ型组37例),术前检测病灶大小,联合治疗后1个月复诊,对比三组患者手术治疗次数、治疗前后病灶缩小程度,分析治疗的有效性及安全性。结果:本组81例患者,治愈率为29.63%,总有效率为60.49%。病灶缩小程度和治疗总有效率均Ⅱ型组>Ⅰ型组>Ⅲ型组,Ⅲ型组治疗次数明显多于Ⅰ型组与Ⅱ型组,以上指标三组比较差异均有统计学意义(P<0.05);所有患者术后未出现呼吸困难、严重过敏、脏器损伤及血管栓塞等严重并发症。结论:B超引导下1470 nm激光联合聚桂醇硬化剂治疗周围动静脉畸形,组织损伤程度小,安全性高,疗效好,并可根据周围动静脉畸形影像学分型采取最佳治疗方案。

Objective To explore the short-term clinical efficacy ultrasound-guided 1470 nm intracavitary laser combined with lauromacrogol foam in the treatment of peripheral arteriovenous malformations.Methods 81 patients diagnosed with peripheral arteriovenous malformations admitted to the author's department from January 2019 to February 2024 were selected.According to the imaging classification of peripheral arteriovenous malformations,the patients were divided into three groups(including 14 cases in type I group,30 cases in typeⅡgroup and 37 cases in typeⅢgroup).The size of the lesion was detected before operation,and the follow-up visit was conducted one month after the combined treatment.The number of surgical treatments and the degree of lesion reduction before and after treatment was compared,and the effectiveness and safety of the treatment were analyzed.Results In this group of 81 patients,the cure rate was 29.63%,the total effective rate was 60.49%.The degree of lesion reduction and the total effective rate of treatment were higher in the typeⅡgroup than in the typeⅠgroup and the typeⅢgroup,and the number of treatment in the typeⅢgroup was significantly more than that in the typeⅠgroup and the typeⅡgroup,showing significant differences among the three groups(P<0.05).No serious complications such as dyspnea,severe allergy,organ injury and vascular embolism occurred in all patients after operation.Conclusion B ultrasound-guided 1470 nm laser combined with lauromacrogol sclerotherapy for peripheral arteriovenous malformations has the advantages of less tissue damage,high safety and good efficacy.The best treatment scheme can be adopted according to the imaging classification of peripheral arteriovenous malformations.