球囊临时阻断联合经皮穿刺硬化治疗颌面部动静脉畸形初探

来源 :中华口腔医学杂志 | 被引量 : 0次 | 上传用户:liu0211yan
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为探讨采用动脉球囊临时阻断联合经皮穿刺硬化方式治疗颌面部动静脉畸形(arteriovenous malformation,AVM)的疗效和安全性,本研究回顾性分析2012年12月至2019年12月就诊于香港大学深圳医院介入科门诊的20例颌面部AVM患者的资料。患者年龄(26.8±3.0)岁(18~36岁),均经数字减影血管造影诊断为AVM,并按照外周AVM的Yakes分类进行分型,介入术中采用球囊临时阻断责任动脉主干,使高流量AVM变为低流量静脉畸形,再经皮穿刺畸形血管注射聚桂醇泡沫硬化进行治疗。比较患者治疗前后的症状及影像学变化,参照Achauer标准评价疗效。其中Ⅱa型AVM占60%(12/20),且治疗均有效;Ⅲb型和Ⅳ型患者的治疗效果较差。20例患者治疗的临床有效率为85%(17/20),临床治愈率为50%(10/20),无皮肤坏死、器官功能受损等严重并发症。存在主要责任供血动脉的颌面部AVM病例适合用球囊临时阻断对应责任动脉主干,再用经皮穿刺硬化治疗处理,此种方法安全有效。“,”To analysis the treatment effectiveness of maxillofacial arteriovenous malformation (AVM) by means of temporary balloon block and percutaneous puncture sclerotherapy. The treatment outcomes of 20 patients with AVM of maxillofacial deformity, aged (26.8±3.0) 18-36 years, from Dec 2012 to Dec 2019 were collected and retrospectively analyzed. All patients had been diagnosed AVM by digital substraction angiography (DSA). All the cases were treated by using balloons to temporary block responsible artery of the AVM in order to change the high-flow malformations into low-flow venous malformation. Then injection of polyethylene foam cinnamyl alcohol was conducted via percutaneous puncturing for hardening the vascular malformation. Comparing the symptoms and imaging changes before treatment with those 1-6 months after treatment according to Achauer curative effect evaluation standard. Totally 60% (12/20) of the cases were type Ⅱa AVM, and their treatments were effective. However, the treatment effects of type Ⅲb and type Ⅳ patients were relatively poor. The clinical effective rate was 85% (17/20), and the clinical curative rate was 50% (10/20). No skin necrosis, organ damage and other serious complications were observed for the 20 patients. The AVM patients with a main supply artery treated by using a balloon artery temporary block to make high flow malformations into low-flow and followed by percutaneous puncture sclerotherapy, could get good curative effect. It seemed that this approach was safe and effective.
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