在局部麻醉下使用低剂量纯乙醇对外周静脉畸形进行门诊经皮治疗。
Outpatient percutaneous treatment of deep venous malformations using pure ethanol at low doses under local anesthesia.
机构信息
Department of Plastic Surgery, Hospital A.C. Camargo, São Paulo, SP, Brazil.
出版信息
Clinics (Sao Paulo). 2010;65(9):837-40. doi: 10.1590/s1807-59322010000900004.
INTRODUCTION
Venous malformations are the most frequent vascular malformation. Deep venous malformations are located in subcutaneous tissue or in the muscles. Percutaneous sclerotherapy is the treatment of choice, and the use of ethanol at low doses has not yet been described.
OBJECTIVE
To analyze the results of treating Deep venous malformations patients with low doses of ethanol.
METHODS
Thirty-nine patients treated between July 1995 and June 2007 were followed up prospectively over a median period of 18 months. Twenty-nine were female (74.4%) and 10 were male (25.6%), with ages ranging from 11 to 59 years (median of 24 years). All of the lesions affected limbs, and the main symptom reported was pain (97.4%). Each patient underwent fortnightly alcohol application sessions under local anesthesia on an outpatient basis. The lesions were classified into three groups according to size using nuclear magnetic resonance imaging: small, up to 3 cm (4 patients); medium, between 3 and 15 cm (27 patients); and large, greater than 15 cm (8 patients).
RESULTS
The symptoms completely disappeared in 14 patients (35.9%) and improved in 24 (61.5%). The lesion size reduced to zero in 6 patients (15.4%) and decreased in 32 (82%). The median number of sessions was 7. There were no complications in 32 patients (82%), while 3 presented local paresthesia (7.7%), 2 superficial trombophlebites (5.1%), 1 skin ulcer (2.6%), and 1 case of hyperpigmentation (2.6%).
CONCLUSION
Outpatient treatment for Deep venous malformations patients using ethanol at low doses was effective, with a low complication rate.
简介
静脉畸形是最常见的血管畸形。深部静脉畸形位于皮下组织或肌肉中。经皮硬化疗法是首选治疗方法，而尚未描述低剂量乙醇的应用。
目的
分析低剂量乙醇治疗深部静脉畸形患者的结果。
方法
1995 年 7 月至 2007 年 6 月期间，对 39 例患者进行了前瞻性随访，中位随访时间为 18 个月。29 例为女性（74.4%），10 例为男性（25.6%），年龄 11-59 岁（中位数 24 岁）。所有病变均累及四肢，主要症状为疼痛（97.4%）。每位患者均在局麻下接受两周一次的酒精应用治疗，在门诊进行。根据磁共振成像结果，根据病变大小将患者分为三组：小，直径<3cm（4 例）；中，3-15cm（27 例）；大，直径>15cm（8 例）。
结果
14 例（35.9%）患者症状完全消失，24 例（61.5%）患者症状改善。6 例（15.4%）患者病变完全消失，32 例（82%）患者病变缩小。中位治疗次数为 7 次。32 例（82%）患者无并发症，3 例出现局部感觉异常（7.7%），2 例出现浅表血栓性静脉炎（5.1%），1 例出现皮肤溃疡（2.6%），1 例出现皮肤色素沉着（2.6%）。
结论
低剂量乙醇治疗深部静脉畸形患者的门诊治疗有效，并发症发生率低。
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