以栓塞硬化为主综合治疗会阴部静脉畸形.docVIP

以栓塞硬化为主综合治疗会阴部静脉畸形[摘要]目的:探讨治疗会阴部海绵状静脉畸形的安全有效方法。方法:用栓塞硬化注射术,或结合手术切除部分硬化瘤体,治疗会阴部海绵状静脉畸形。结果:治疗患者33例,其中20例只进行栓塞硬化治疗。13例栓塞硬化后手术切除治疗。所有患者治疗后会阴部瘤体缩小,未出现并发症。23例完全治愈,随访6个月至4年,治疗部位无复发,局部功能形态良好。结论:以栓塞硬化为主综合治疗会阴部海绵状静脉畸形,简便有效,创伤小,不易复发。 [关键词]海绵状静脉畸形;会阴部;栓塞;硬化;手术 [中图分类号]R732.2[文献标识码]A [文章编号]1008-6455(2010)09-1272-02 Proven protocol of embolization and sclerotherapyfor venous malformation of perineum LIU Jun,OUYANG Tian-xiang,YU Jie,CHEN Hui-ping,HUANG Ying-ying,XIAO Yan,LIN Jun (Department of Plastic Surgery,Xinhua Hospital, School of Medicine,Shanghai Jiaotong University,Shanghai 200092,China) Abstract:ObjectiveTo evaluate the effect of treatment for venous malformation of perineum.MethodsThe embolization and sclerotherapy,combined with surgical excision or not,was used to treat the venous malformation of perineum.Surveys were sent to all study patients,to assess perceived improvements in symptoms and satisfaction with the results.ResultsA total of 33 patients with venous malformation of perineum were treated,20/33 were treated by the embolization and sclerotherapy only,13/33 were treated by combining with the surgical excision,all have marked decrease lesion and 20 were cured. All had good shape and function after treatment.Follow-up from 6 months to 4 years revealed that this methods had improved contour and function without recurrence. ConclusionThe embolization and sclerotherapy is a safe technique to objectively decrease size and subjectively alleviate symptoms of perineum VMs. Key words: venous malformation;perineum;embolization;sclerotherapy;surgery 海绵状静脉畸形,又称海绵状血管瘤,属于低流量性的静脉畸形[1]。海绵状静脉畸形因为其范围广泛、血流丰富、经常累及多处组织器官,手术切除出血多,术后畸形明显,易复发,一直是临床的治疗难题[2]。长期以来笔者利用以栓塞硬化为主的综合疗法对体表静脉畸形的治疗还是卓有成效[3]。而会阴部海绵状静脉畸形,尽管其发生率较躯干静脉畸形的发病率低,但因部位特殊,治疗上更有难度,自1992年以来,笔者采用栓塞硬化为主,结合手术,治疗会阴部海绵状静脉畸形,获得创伤小、形态满意、不易复发的良好效果。 1临床资料 本组33例会阴部海绵状静脉畸形均侵及会阴部皮肤、粘膜至皮下或海绵体,呈青紫包块。其中男13例,女20例。年龄5～46岁。根据肿瘤主要分布部位来确定本次治疗范围,大体分为:龟头(女性为阴蒂)、阴囊(女性为大小阴唇)、肛周。其中5例为龟头静脉畸形,9例阴蒂静脉畸形以及伴发大、小阴唇静脉畸形。1例海绵状静脉畸形