Division of Vascular and Interventional Radiology, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
AJR Am J Roentgenol. 2012 Sep;199(3):691-4. doi: 10.2214/AJR.11.8285.
The purpose of this article is to study the incidence, risk factors, and treatment of gross hemoglobinuria and oliguria following sclerotherapy for venous malformations.
The clinical records and imaging studies of 131 patients with venous malformations (57 male and 74 female patients; age range, 2-58 years) who underwent sclerotherapy at our institution between July 1993 and August 2007 were reviewed. Demographic data, the location and estimated size of the malformation, the type and dose of the sclerosing agents, development of postprocedural hemoglobinuria and oliguria, and the treatment given were documented and analyzed.
Four hundred seventy-five sclerotherapy procedures were performed on 131 patients, with the number of procedures per patient ranging from 1 to 21 (mean, 3.6 procedures). Sodium tetradecyl sulfate was used in 47% of the procedures, ethanol in 27%, and both agents in 26%. Transient hemoglobinuria occurred after 34% of the sclerotherapy procedures, and 57% of these were associated with transient oliguria, with increased risk with higher adjusted doses (sclerosant volume/weight of patient) for both agents. Resolution of the hemoglobinuria and oliguria with hydration, alkalinization, and diuretics occurred in all patients. The risk of hemoglobinuria increased with higher adjusted dose (sclerosant volume/weight of patient) for both agents and with sclerotherapy of venous malformations affecting the lower extremities and multiple locations.
Transient hemoglobinuria and oliguria are common complications of sclerotherapy for venous malformation. Nevertheless, with proper fluid management, all the patients promptly recovered. The risk correlates with the volume of sclerosant (adjusted to patient's weight) and is higher for lower extremity and multiple locations.
本文旨在研究静脉畸形硬化治疗后血红蛋白尿和少尿的发生率、危险因素和治疗方法。
回顾 1993 年 7 月至 2007 年 8 月在我院接受硬化治疗的 131 例静脉畸形患者（男 57 例，女 74 例；年龄 2-58 岁）的临床记录和影像学研究。记录并分析人口统计学数据、畸形的位置和估计大小、硬化剂的类型和剂量、术后血红蛋白尿和少尿的发生情况以及所给予的治疗方法。
131 例患者共进行了 475 次硬化治疗，每位患者的治疗次数为 1-21 次（平均 3.6 次）。其中 47%的病例使用十四烷基硫酸钠，27%使用乙醇，26%同时使用两种药物。34%的硬化治疗后出现短暂性血红蛋白尿，其中 57%伴有短暂性少尿，两种药物的调整剂量（硬化剂体积/患者体重）越高，风险越大。所有患者均通过水化、碱化和利尿剂治疗使血红蛋白尿和少尿得到缓解。血红蛋白尿的风险随着两种药物的调整剂量（硬化剂体积/患者体重）以及下肢和多个部位的静脉畸形硬化治疗而增加。
短暂性血红蛋白尿和少尿是静脉畸形硬化治疗的常见并发症。然而，通过适当的液体管理，所有患者均迅速康复。风险与硬化剂的体积（按患者体重调整）相关，且下肢和多个部位的风险更高。
