4例儿童期颌骨动静脉畸形血管复通的再治疗

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (4): 329-333.

4例儿童期颌骨动静脉畸形血管复通的再治疗

黄子贤¹, 陈耀庭², 李世豪¹, 范松¹, 张大明¹, 汪延¹, 严凌健¹, 陈伟良¹, 黄志权¹

1.中山大学孙逸仙纪念医院口腔颌面外科,
2.介入科,广东广州 510120

出版日期:2017-08-10 发布日期:2017-08-14
通讯作者: 黄志权,E-mail：zhiquanhuang1978@126.com
作者简介:黄子贤(1991-),男,硕士,E-mail: zeahuang@hotmail.com

Treatment of recanalization of maxillary and mandibular arteriovenous malformations in 4 pediatric patients

HUANG Zi-xian¹, CHEN Yao-ting², Li Shi-hao¹, FAN Song¹, ZHANG Da-ming¹, WANG Yan¹, YAN Ling-jian¹, CHEN Wei-liang¹, HUANG Zhi-qaun¹

1.Department of Oral and Maxillofacial Surgery,Sun Yat-sen University. Guangzhou 510120, Guangdong Province, China
2.Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Guangzhou 510120, Guangdong Province, China

Online:2017-08-10 Published:2017-08-14

摘要/Abstract

摘要： 目的总结治疗儿童期上、下颌骨动静脉畸形治疗后血管复通的临床经验。方法回顾分析4例儿童期颌骨动静脉畸形（arteriovenous malformations, AVMs）患者的临床资料。所有患者均接受过至少26个月以上的颌骨AVM的多学科综合治疗,包括超选择性动脉内栓塞、颌骨骨腔内骨蜡填塞联合拔牙术,并应用计算机体层血管造影术（CTA）及数字减影血管造影术（DSA）证实AVM治疗后存在血管复通。对出现血管复通的患者,再次施以超选择性动脉内栓塞联合颌骨骨腔内骨蜡填塞及拔牙（如有必要）的综合治疗。结果4例患者随访5~14个月,平均9.5个月,均预后良好,无治疗后搏动感存在或出血。结论儿童期颌骨AVM综合治疗后,极少病例出现治疗后血管复通,再次应用超选择性动脉内栓塞联合颌骨骨腔内骨蜡填塞以及拔牙等综合治疗效果良好,值得推广应用。

关键词: 动静脉畸形, 复通, 超选择性动脉内栓塞, 骨蜡填塞

Abstract: PURPOSE: This study reviewed our experience in treating recanalization of maxillary and mandibular arteriovenous malformations in 4 pediatric patients. METHODS: Four patients with maxillary or mandibular arteriovenous malformations (AVMs) were included in this study. All patients had undergone multidisciplinary treatment of AVM at least 26 months before this review, including superselective intra-arterial embolization combined with bone wax packing(BWP). Computed tomographic angiography and digital subtraction angiography (DSA) were performed to confirm the presence of recanalization. Superselective intra-arterial embolization combined with BWP and tooth extractions were performed in the patients with AVM recanalization. RESULTS: After confirmation of the recanalization of AVM by DSA, the patients were treated with superselective intra-arterial embolization combined with BWP and tooth extractions (if necessary). All patients were followed up for 5 to 14 months, with an average of 9.5 months. The outcome for all patients was good, and no patient complained of pulsatile sensation or hemorrhage after treatment. CONCLUSIONS: In the treatment for recanalization of maxillary and mandibular AVMs, reapplication of superselective intra-arterial embolization, combined with BWP, remains necessary.

Key words: Arteriovenous malformations, Recanalization, Superselective intra-arterial embolization, Bone wax packing

中图分类号:

R739.8

黄子贤, 陈耀庭, 李世豪, 范松, 张大明, 汪延, 严凌健, 陈伟良, 黄志权. 4例儿童期颌骨动静脉畸形血管复通的再治疗[J]. 中国口腔颌面外科杂志, 2017, 15(4): 329-333.

HUANG Zi-xian, CHEN Yao-ting, Li Shi-hao, FAN Song, ZHANG Da-ming, WANG Yan, YAN Ling-jian, CHEN Wei-liang, HUANG Zhi-qaun. Treatment of recanalization of maxillary and mandibular arteriovenous malformations in 4 pediatric patients[J]. China J Oral Maxillofac Surg, 2017, 15(4): 329-333.

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