【作者】 杨宏宇； 罗娟； 黄晓斌； 杨辉峻； 杜端明； 孙顺涛； 储眉；

【Author】 YANG Hong-yu LUO Juan HUANG Xiao-bing (Department of Oral and Maxillofacial Surgery,Shenzhen Hospital,Peking University,Shenzhen 518036,China)

【机构】 北京大学深圳医院口腔颌面外科；

【摘要】 目的:探讨 DSA 引导下经皮无水乙醇注射治疗颌面部大面积静脉畸形有效性和安全性。方法:7例患者,男4 例,女3例。平均年龄21岁,从11岁38岁。治疗前5例 MRI 检查,2例巨大病变行 MRA 检查,其中1例行三维 CT 检查。均经 DSA 检查证实为低流速静脉畸形,并在 DSA 引导荧光屏直视下经皮注无水乙醇。治疗后3～6月后均行 MRI 复查。随访8～30月,平均18月。结果:病变消退达95%以上6例。1例病变位于颌下和口底分为高流速和低流速两部分只治疗低流速部分仅消退80%,但治疗后患者吞咽、语言、睡眠时呼吸功能均有明显改善。其余6例治疗前的不适症状和体位移动试验阳性均已消失,患者满意,期内未见复发。一例治疗后患侧颞颌关节区不适和轻度开口困难,3月后恢复正常。无皮肤溃疡、坏死、神经损伤等并发症发生。结论:DSA 引导下经皮无水乙醇注射治疗颌面部低流速大面积静脉畸形是有效的、安全的、微创的、可靠的。DSA 引导荧光屏直视下经皮注入可减少并发症的发生, 增加安全性。更多还原

【Abstract】 PURPOSE:To study the safety and effectiveness of DSA-guided percutaneous ethanol sclerotherapy of large venous malformations in the maxillofacial region.METHODS:Eight percutaneous ethanol sclerotherapy procedures were performed with DSA guidance in seven patients.Four patients were male and three were female.Patients age ranged from 11 to 38 years(mean age,21 years).Five cases were detected by MRI,two of seven with large lesions by MRA,one of two by three dimension CT.All cases with low-flow venous malformationwere treated using DSA-guided percutaneous ethanol sclerotherapy under fluoroscopy.MRI underwent in all cases 3 to 6 months after treating.Follow-up was 8 to 30 months (mean,18 months).RESULTS:The regression of lesions are more than 95% in 6 cases.Selerotherapy provided significant improvement or resolution of symptoms in all cases.There are no major complications.CONCLUSION:DSA-guided percutaneous ethanol sclerotherapy provides a safe,effective,reliable,minimally invasive treatment modality for large venous malformations in the maxillofacial region.DSA guidance with under fluoroscopy decreased complications of percutaneous ethanol sclerotherapy for large venous malformations in the maxillofacial region.更多还原