射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化剂灌注治疗口腔颌面部静脉畸形38例疗效评价

doi:10.19438/j.cjoms.2022.02.006

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (2): 135-140.doi: 10.19438/j.cjoms.2022.02.006

射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化剂灌注治疗口腔颌面部静脉畸形38例疗效评价

庄乾伟, 李芳芳, 孟箭, 顾倩平, 李志萍

徐州市中心医院·南京医科大学徐州临床医学院口腔科,江苏徐州 221009

收稿日期:2021-09-27 修回日期:2021-11-08 出版日期:2022-03-20 发布日期:2022-03-20
通讯作者: 孟箭, E-mail: mrocket@126.com
作者简介:庄乾伟(1986-),女,硕士,主治医师,E-mail: 200450806006z@sina.com
基金资助:
国家口腔疾病临床医学研究中心项目（NCRCO202101）; 徐州市重点研发计划项目（KC21187）

Radiofrequency ablation combined with DSA-guided sclerotherapy of polidocanol foam for38patients with oral, maxillofacial venous malformation

ZHUANG Qian-wei, LI Fang-fang, MENG Jian, GU Qian-ping, LI Zhi-ping

Department of Stomatology, Xuzhou Central Hospital, Xuzhou Clinical School of Nanjing Medical University. Xuzhou 221009, Jiangsu Province, China

Received:2021-09-27 Revised:2021-11-08 Online:2022-03-20 Published:2022-03-20

摘要/Abstract

摘要： 目的:探讨射频消融联合经皮造影数字DSA引导下聚多卡醇泡沫硬化治疗静脉畸形的疗效。方法:回顾性分析徐州市中心医院2019—2020年收治的38例静脉畸形患者的临床资料。所有患者均接受射频消融联合DSA引导下聚多卡醇泡沫硬化治疗。随访至少6个月,观察并评价疗效。结果:按Puig分型,Ⅰ型20例,Ⅱ型18例。所有患者均行射频消融及DSA引导下聚多卡醇泡沫硬化治疗2~4次。采用Tessari法,按1%聚多卡醇与空气比例1∶3制备泡沫。治愈8例,有效29例,效果不明显1例。治愈率为21.05%(8/38),总有效率为97.37%(37/38)。38例患者经介入硬化治疗后均出现轻度肿胀,3天后肿胀逐渐消退。发生皮肤张力性水疱2例,轻度皮肤溃疡1例,经对症处理后治愈。对症治疗10天后,皮肤愈合过程中未出现过敏反应、异位栓塞、局部或全身感染等严重并发症。随访无复发、窒息、皮肤破裂、瘘管等严重并发症。结论:根据Puig分型,选择射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化治疗口腔颌面部静脉畸形安全有效。

关键词: 口腔颌面部, 静脉畸形, 射频消融, DSA, 聚多卡醇

Abstract: PURPOSE: To investigate the effect of combination of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam in patients with oral and maxillofacial venous malformations. METHODS: The clinical data of 38 patients with venous malformation in Xuzhou Central Hospital from 2019 to 2020 were retrospectively analysed. All patients underwent combined therapy of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam. The curative effect was observed in follow-up of minimum 6 months. RESULTS: The patients were divided into 2 groups according to Puig's classification, type Ⅰ(n=20) and type Ⅱ(n=18). All patients underwent radiofrequency ablation as well as DSA-guided sclerotherapy of polidocanol foam for 2-4 sessions. Polidocanol foam was made by means of Tessari's method with the ratio of 1:3(1% polidocanol vs air). Eight cases were cured, 29 cases were basically cured and 1 was less effective. The cure rate was 21.05%(8/38), and the total effective rate was 97.37%(37/38). All 38 cases had mild swelling after sclerotherapy, and the swelling gradually subsided after 3 days. Two cases had skin tension blisters, and 1 case had mild skin ulceration cured after symptomatic treatment. No serious complications such as allergic reaction, ectopia embolism, local or systemic infection occurred. Postoperative follow-up was conducted for 6-12 months. No recurrence, choke, skin rupture, fistula and other serious complications were found. CONCLUSIOINS: According to Puig's classification, it is safe and effective to select combination of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam in patients with oral and maxillofacial venous malformations.

Key words: Oral and maxillofacial region, Venous malformation, Radiofrequency ablation, DSA, Polidocanol foam

中图分类号:

R739.8

庄乾伟, 李芳芳, 孟箭, 顾倩平, 李志萍. 射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化剂灌注治疗口腔颌面部静脉畸形38例疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(2): 135-140.

ZHUANG Qian-wei, LI Fang-fang, MENG Jian, GU Qian-ping, LI Zhi-ping. Radiofrequency ablation combined with DSA-guided sclerotherapy of polidocanol foam for38patients with oral, maxillofacial venous malformation[J]. China J Oral Maxillofac Surg, 2022, 20(2): 135-140.

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射频消融联合经皮造影DSA引导下聚多卡醇泡沫硬化剂灌注治疗口腔颌面部静脉畸形38例疗效评价

Radiofrequency ablation combined with DSA-guided sclerotherapy of polidocanol foam for38patients with oral, maxillofacial venous malformation

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