Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Shaanxi, China.
J Vasc Surg. 2010 Apr;51(4):940-5. doi: 10.1016/j.jvs.2009.11.038.
To evaluate the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin A5 on treatment of venous malformation (VM) in cervical-facial region.
Seventy-five patients (32 male, 43 female), ranging in age from 13 to 60 years old, suffering from VM in cervical-facial region were admitted to and treated at our hospital between June 2006 and February 2007. Of all the patients, 54 malformations were located in the facial region, eight in the submental region, 10 in the submandible region, and three in the cervical region; all were treated by ultrasound-guided intralesional injections of bleomycin A5. The size of the lesions ranged from 6 x 9 mm to 32 x 39 mm. Injection of bleomycin A5 on venous malformation was then carried out through the inspection of ultrasonography. Repeated course of bleomycin A5 injection was administrated for larger malformations. The amount was 8 mg each time. The therapeutic interval was two to four weeks. The therapeutic outcome on venous malformation was evaluated by physical examination and ultrasonography with Doppler according to the Shou standards, including four grades; cured, basically cured, improved, and invalid. The complications were also observed during and after injection.
The duration of follow-up ranged from 6 to 24 months. The average times of treatment were 1.64 times. Among them, 42 patients (56%) received only one time of treatment, 21 (28%) patients received two times, nine (12%) patients received three times, and three (4%) patients received four times. According to criteria of therapeutic outcome, the results showed cured in 63 patients (84%), basically cured in 10 patients (13.33%), improved in two patients (2.67%), and none ineffective. Seventy-one patients (94.67%) had local swelling in injection region for several days and two patients (2.67%) developed temporary dizziness after treatment. There were no other complications recorded.
Intralesional injection of bleomycin A5 establishes a promisingly effect way for patients suffering from VM in the cervical-facial region under ultrasound guidance.
评估超声引导下腔内注射平阳霉素治疗头颈部静脉畸形（VM）的疗效。
2006 年 6 月至 2007 年 2 月，我院收治 75 例头颈部静脉畸形患者（男 32 例，女 43 例），年龄 13～60 岁。54 例病变位于面颈部，8 例位于颏下，10 例位于下颌下，3 例位于颈部。所有患者均在超声引导下进行平阳霉素腔内注射治疗。病变大小 6×9～32×39mm。超声检查引导下向静脉畸形内注射平阳霉素。较大的病变重复注射平阳霉素，每次 8mg。治疗间隔 2～4 周。根据 Shou 标准，通过体格检查和超声多普勒评估静脉畸形的治疗效果，包括四级：治愈、基本治愈、好转和无效。观察治疗过程中和治疗后的并发症。
随访 6～24 个月，平均 1.64 次。其中 42 例（56%）患者仅接受 1 次治疗，21 例（28%）患者接受 2 次，9 例（12%）患者接受 3 次，3 例（4%）患者接受 4 次。根据疗效标准，治愈 63 例（84%），基本治愈 10 例（13.33%），好转 2 例（2.67%），无效 0 例。71 例（94.67%）患者注射部位局部肿胀数天，2 例（2.67%）患者治疗后出现短暂头晕。无其他并发症。
超声引导下腔内注射平阳霉素治疗头颈部静脉畸形是一种有前途的方法。
