经皮射频消融治疗小儿Kasabach-Merritt现象初步报道

doi:10.19438/j.cjoms.2019.02.016

中国口腔颌面外科杂志 ›› 2019, Vol. 17 ›› Issue (2): 175-180.doi: 10.19438/j.cjoms.2019.02.016

经皮射频消融治疗小儿Kasabach-Merritt现象初步报道

葛春晓, 陈涛, 邰茂众, 李克雷, 秦中平

山东省临沂市肿瘤医院省级血管瘤特色专科,山东临沂 276001

收稿日期:2018-12-14 修回日期:2019-02-22 出版日期:2019-03-20 发布日期:2019-04-12
通讯作者: 秦中平,E-mail:qinzhongping1962@163.com
作者简介:葛春晓（1982-）,男,硕士,主治医师,E-mail: gechunxiao1982@163.com

Percutaneous radiofrequency ablation for children with Kasabach-Merritt phenomenon: a preliminary report

GE Chun-xiao, CHEN Tao, TAI Mao-zhong, LI Ke-lei, QIN Zhong-ping

Special Department of Vascular Anomalies. Linyi Tumor Hospital. Linyi 2760001, Shandong Province, China

Received:2018-12-14 Revised:2019-02-22 Online:2019-03-20 Published:2019-04-12

摘要/Abstract

摘要： 目的:总结经皮射频消融治疗小儿Kasabach-Merritt现象（KMP）的临床经验,评价其临床疗效和安全性。方法:对2014年10月—2015年8月间临沂市肿瘤医院收治的3例KMP患儿进行经皮射频消融术。患儿入院前均接受多方治疗,无明显疗效,病情呈进展趋势。消融采用“伞状动态”技术,原发病变评价采用Achauer 等提出的4级分级标准,凝血指标变化过程评价分为无效、缓解、明显缓解和治愈。结果:随访时间均大于3年,原发病变疗效评价1例为Ⅲ级,2例为Ⅳ级。实验室检查结果3例均评定为治愈。3例治疗后出现发热,1例应用类固醇激素后24 h恢复正常,其余2例未经治疗恢复正常。结论:经皮射频消融术治疗KMP疗效确切,创伤小,并发症可控,是一种有效的替代方案,尤其适用于伴有深部复杂病变的KMP。

关键词: 卡波西样血管内皮细胞瘤, 射频消融术, Kasabach-Merritt现象

Abstract: PURPOSE: To summarize the clinical experiences of percutaneous radiofrequency ablation for children with Kasabach-Merritt phenomenon(KMP), and to evaluate its clinical efficacy and safety. METHODS: From October 2014 to August 2015, three children with KMP in Linyi Tumor Hospital received percutaneous radiofrequency ablation. All patients received multiple treatments before admission without obvious curative effect, and the condition showed a trend of evolution. Percutaneous radiofrequency ablation (RFA) is based on "umbrella-like and dynamic" ablation techniques. The evaluation of primary lesions was based on the four scale grading system proposed by Achauer et al. The results of coagulation function evaluation were divided into ineffective, improved, significantly improved and cured. RESULTS: After follow-up for more than 3 years, one case achieved Achauer grade Ⅲ and 2 cases achieved Achauer grade Ⅳ of response for primary lesions of evaluation, and all 3 cases were evaluated as cured for coagulation function evaluation. Hyperpyrexia occurred in 3 patients,and one returned to normal 24 hours after ablation with intravenous dehydrocortisol, whereas the other 2 returned to normal 24 hours later without any medical intervention. CONCLUSIONS: Percutaneous radiofrequency ablation is an effective alternative therapy for KMP with definite efficacy, minimal injury and controllable complications, especially for deep and complex lesions.

Key words: Kaposiform hemangioendothelioma, Radiofrequency ablation, Kasabach-Merritt phenomenon

中图分类号:

R739.8

葛春晓, 陈涛, 邰茂众, 李克雷, 秦中平. 经皮射频消融治疗小儿Kasabach-Merritt现象初步报道[J]. 中国口腔颌面外科杂志, 2019, 17(2): 175-180.

GE Chun-xiao, CHEN Tao, TAI Mao-zhong, LI Ke-lei, QIN Zhong-ping. Percutaneous radiofrequency ablation for children with Kasabach-Merritt phenomenon: a preliminary report[J]. China J Oral Maxillofac Surg, 2019, 17(2): 175-180.

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经皮射频消融治疗小儿Kasabach-Merritt现象初步报道

Percutaneous radiofrequency ablation for children with Kasabach-Merritt phenomenon: a preliminary report

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