体表巨大血管畸形介入诊断分型及治疗.docVIP

体表巨大血管畸形介入诊断分型及治疗[摘要]目的:研究体表巨大血管畸形的介入诊断和治疗方法。方法:对32例体表巨大血管畸形患者进行介入治疗,瘤体位于颌面部、躯干、四肢等处。在透视下经股动脉穿刺,导丝引导下插入微导管至病变部位,注射造影剂碘海醇,根据血管特征,分为动静脉瘘或静脉畸形或混合血管畸形等不同类别,对于动静脉瘘以NBCA胶或明胶栓塞治疗,对于静脉畸形则向病变内部注射碘油+平阳霉素+明胶海绵颗粒混合物。结果:动静脉畸形和静脉畸形分别进行栓塞或硬化治疗后,病变区域皮肤颜色变浅,患者48h内局部均有肿胀感甚至疼痛,瘤体逐步萎缩变小,血管搏动减弱或消失。结论:介入下可以对血管畸形进行准确诊断和分型,同时进行栓塞或硬化治疗可以取到良好的治疗效果,对于位于重要脏器和结构周围的巨大病变十分安全有效。 [关键词]血管畸形;介入;血管造影;栓塞 [中图分类号]R732.2[文献标识码]A[文章编号]1008-6455(2010)04-0479-03 DSA diagnosis and interventional embolization therapy on body surface gaint vascular malformation TANG Jian-bing1,LI Qin1,CHENG Biao1,LIU Da-lie2,YU Wen-lin1,ZENG Dong1 (1.Department of Plastic Surgery,Guang Zhou Military Command General Hospital; 2. Department of Plastic Surgery,Zhujiang Hospital,Southern Medical University) Abstract:ObjectiveTo explore the diagnosis and therapy of the body surface gain vascular malformation.Methods32 patients with gaint vascular malformation on the body surface in the maxilloface and trunk or four limbs were treated. Punctured to the lesion place through the femoral artery on X-ray, the main blood supply vessels of arteriovenous fistula were embolismed by NBCA or gelatin. Lipiodol and gelatin mixed with pingyangmycin was injeceted to the central of the venous malformation.ResultsThe main supply vessel of the vascular malformation was showed through angiography. After selective embolism, the color of the vascular malformation become light, and little pain and swollen appeared in 48h, the lesion degressive gradually, the pulse of vessel weakened.ConclusionThe gaint vascular malformation can be diagnosis and typing accurately and be treated effectively through intervention therapy especially for the vascular malformation arround the important organ and structure. Key words: vascular malformation; intervention; angiography; embolism therapy 体表血管性疾病在临床上十分常见,现在通常根据细胞生物学特性将它们分为两大类:血管瘤和血管畸形,其中血管畸形又根据不同的组织结构分为毛细血管畸形,静脉畸形和动静脉畸形。它们有相应的治疗方法[1]。从2006年至2008年12月笔者共治疗体表巨大血管畸形32例。笔者采用介入诊断治疗,取得了良好的疗效。现总结如下。