Angel C, Yngve D, Murillo C, Hendrick E, Adegboyega P, Swischuk L
Department of Surgery, Division of Pediatric Surgery, The University of Texas Medical Branch, Galveston, TX 77555, USA.
Pediatr Surg Int. 2002 Mar;18(2-3):213-7. doi: 10.1007/s003830100636.
The treatment of vascular malformations (VM) of the extremities is controversial. Six patients with large, localized, symptomatic VMs of the extremities underwent surgical excision. In five cases abnormal vessels were apparent under the skin; in two of these there was also red discoloration of the skin secondary to skin involvement. Magnetic resonance imaging was the most helpful imaging modality in evaluating these patients. Subfascial resection was performed in five cases. Muscle was involved in four patients and was removed in all four cases. At follow-up, there was improvement in symptoms and function with no clinically apparent recurrence an average of 30 months following the operation. There was improvement in pain intensity from an average of 4.3 on a scale of 1 to 10 before surgery to 1.3 after surgery. Surgical excision of localized VMs that are extensive and include fascia and muscle, as appropriate, can successfully improve pain and function without evidence of recurrence at 1 to 5 years of follow-up.
四肢血管畸形（VM）的治疗存在争议。6例患有大型、局限性、有症状的四肢VM患者接受了手术切除。5例患者的皮下可见异常血管；其中2例还因皮肤受累出现皮肤发红。磁共振成像在评估这些患者时是最有用的成像方式。5例患者进行了筋膜下切除术。4例患者的肌肉受累，均予以切除。随访时，症状和功能均有改善，术后平均30个月无临床明显复发。疼痛强度从术前平均1至10分的4.3分改善至术后的1.3分。对广泛且酌情包括筋膜和肌肉的局限性VM进行手术切除，可成功改善疼痛和功能，随访1至5年无复发迹象。
