选择性血管结扎在手术治疗动静脉畸形中应用.docVIP

选择性血管结扎在手术治疗动静脉畸形中应用 　　[摘要] 目的 探讨选择性血管结扎后平阳霉素血管腔内注射联合手术切除治疗肢体动静脉畸形的临床疗效。 方法 26例肢体动静脉畸形患者术前均行血管造影，A组15例术中分离结扎病灶主要供血血管，用平阳霉素于结扎血管腔内注射后病灶切除，B组11例术中不结扎主要供血血管，观察分析术后临床疗效。 结果 26例患者术后随访1～12个月，其中A组治愈占80.0%（B组63.6%），显效13.3%（B组18.2%），好转6.7%（B组18.2%），两组疗效差异有统计学意义（Z=-2.975，P0.05）。 结论 选择性血管结扎后平阳霉素腔内注射联合手术切除治疗肢体动静脉畸形是一种安全、有效的治疗方法。 　　[关键词] 平阳霉素；动静脉畸形；手术治疗 　　[中图分类号] R651.2 [文献标识码] B [文章编号] 1673-9701（2015）01-0153-03 　　The application of selective vessel ligation in operative treatment of arteriovenous malformations 　　HU Zhengxiang CHEN Shijiu YANG Jun FANG Hong LI Zhi LONG Hang 　　Department of Plastic Surgery and Burn， the Fifth Affiliated Hospital of Zunyi Medical College，Zhuhai 519100， China 　　[Abstract] Objective To research the clinical effect of extremity arteriovenous malformations by combining intravascular injection of pingyangmycin with surgical excision after the vessel selectively ligated. Methods 26 patients with arteriovenous malformations were treated with combining intravascular injection of pingyangmycin with surgical excision. All the patients were diagnosed by angiography before operative treatment. Separating and ligaturing the main nutrient artery during operation in group A（15 cases），but group B（11 cases）not. Observed and evaluated the clinical effect of postoperation. Results All patients were followed up for 1-12 mouths， in group A， 80.0% were cured（63.6% in group B），13.3% markedly improved（18.2% in group B）， and 6.7% improved（18.2% in group B）. The curative effect between the two groups had statistical significance（Z=-2.975，P0.05）. Conclusion Combining intravascular injection of pingyangmycin with surgical excision after the vessel selectively ligated was the effective and safe way to treat extremity arteriovenous malformations. 　　[Key words] Pingyangmycin；Arteriovenous malformations；Operative treatment 　　动静脉畸形是胚胎血管发生过程中结构异常，血管内皮细胞无异常增殖，随年龄而逐渐增大，不会发生自然消退。动静脉畸形可发生于身体任何部位，以颅内、颜面部和四肢多见[1]，常严重影响局部皮肤、肌体组织的结构和外观，导致畸形和功能障碍，影响患者的生活质量。目前的治疗方法有外科手术、覆膜支架、弹簧圈栓塞