彩色多普勒超声辅助下体表静脉畸形栓塞硬化治疗.docVIP

彩色多普勒超声辅助下体表静脉畸形栓塞硬化治疗[摘要]目的：探讨应用彩色多普勒超声观察栓塞硬化治疗体表静脉畸形的疗效。方法：治疗前、后常规行彩超检查，探测方法包括二维超声、脉冲波多普勒、彩色多普勒血流显像、血流频谱分析。经皮直接穿刺入病灶窦腔内，先用无水乙醇分次注射栓塞回流静脉，然后将含有抗肿瘤药物甲氨蝶呤的硬化剂鱼肝油酸钠注入瘤腔内，至瘤体变硬，术中应用彩色多普勒超声实时监测观察。结果：本组16例患者，治愈3例，有效3例，治愈率81.25%，有效率100%。结论：彩色多普勒超声在体表静脉畸形的栓塞硬化治疗中能够观察评价疗效，在治疗中可实时监测栓塞硬化结果，明显提高治疗效果和安全性。 [关键词]静脉畸形；栓塞硬化治疗；彩色多普勒超声 [中图分类号]R732.2[文献标识码]A [文章编号]1008-6455（2008）08-1181-04 The application of color doppler ultrasound in the embolization and sclerotherapy of surface venous malformations CAO Ying,OUYANG Tian-xiang (Department of Plastic Surgery,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,200092，China) Abstract: Objective To explore the effective method of embolization and sclerotherapy for surface venous malformations with the application of color doppler ultrasonography. Methods Having the inspection of color doppler ultrasound before and after the treatment, including bidimensional ultrasound,PW,CDFI and doppler spectral patterns. Percutaneous embolization of surface venous lesions with absolute ethanol, and thensclerotherapy the lesions with the mixture of sodium morrhuate and methotrexate. During the treatment, using color doppler ultrasound to dynamic observe the lesions.ResultsIn this group, 16 patients were treated, 13 patients(81.25%) were cured and 3 patients were improved. The effective rate is 100%. Conclusion The method is a safe and reliable technique. It can improve curative effect and increase safety. Key words: venous malformations;embolization and sclerotherapy;color doppler ultrasound 静脉畸形为人体最常见的先天性血管疾患之一，以面颈部、四肢为好发部位，多见于皮肤和皮下组织。尽管为一种良性病变，但它能破坏组织形态或影响功能，严重者因疼痛影响四肢功能甚至致残[1]，位于外露部位的病灶还可造成外观的缺陷并影响容貌美，给患者带来极大的精神和心理负担[2-3]。静脉畸形常用的治疗方法很多，但效果不一。我们采用的栓塞硬化治疗方法[4]（即先用无水乙醇栓塞畸形静脉的回流静脉后，再注射甲氨蝶呤和鱼肝油酸钠混合液硬化治疗），临床应用效果较好，但存在一定风险。为了进一步提高栓塞硬化治疗静脉畸形的效果及安全性，2006年8月～2008年1月，我们采用栓塞硬化方法治疗了16例体表静脉畸形患者，应用彩色多普勒超声在治疗前后观察比较治疗效果，并在治疗过程中实时监测，取得了较好效果。 1临床资料和方法 1.1 一般资料：本组共16例，其中男10例，女6例，年龄2～36岁，平均为12.6岁。病灶直径介于1～2