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经皮硬化治疗术联合平阳霉素治疗血管畸形。

Percutaneous sclerotherapy using bleomycin for the treatment of vascular malformations.

机构信息

Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.

Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

出版信息

Int J Dermatol. 2017 Nov;56(11):1186-1191. doi: 10.1111/ijd.13733. Epub 2017 Sep 4.

Abstract

BACKGROUND

Some vascular malformations are difficult to manage with surgical treatment. Thus, percutaneous sclerotherapy has been utilized with several advantages over surgical treatment. Bleomycin is one of several sclerosing agents used for the treatment of vascular malformations.

OBJECTIVES

To evaluate therapeutic efficacy and safety of percutaneous sclerotherapy using bleomycin for the treatment of vascular malformations.

METHODS

Thirty patients diagnosed with vascular malformations, including four with capillary malformations with nodular change, nine with lymphatic malformations, and 17 with venous malformations, were involved in the study. Patients received magnetic resonance imaging and pulmonary surveillance prior to the treatment. Clinical assessments for the degree of vascularity disappearance and adverse effects were performed by the investigator.

RESULTS

Percutaneous sclerotherapy using bleomycin was performed in 3.2 sessions (mean) over 3 months (mean). Significant improvement was observed in 90.0% of all lesions. All lesions of capillary malformation with nodular change and lymphatic malformation demonstrated significant improvement, and 82.4% of lesions of venous malformation improved significantly. Seven patients (23.3%) complained of side effects including pain and headache. All occurred within 24 hours and were tolerable.

CONCLUSIONS

Percutaneous sclerotherapy using bleomycin is effective and tolerable in the treatment of vascular malformation through a percutaneous approach. Therefore, it could be applied usefully for vascular malformations by dermatologists.

摘要

背景

一些血管畸形难以通过手术治疗来控制。因此,经皮硬化治疗已经具有优于手术治疗的多个优势。平阳霉素是用于治疗血管畸形的几种硬化剂之一。

目的

评估经皮平阳霉素硬化治疗血管畸形的疗效和安全性。

方法

本研究纳入了 30 名诊断为血管畸形的患者,包括 4 名毛细血管畸形伴结节性改变患者、9 名淋巴管畸形患者和 17 名静脉畸形患者。患者在治疗前接受磁共振成像和肺监测。研究者对血管消失程度和不良反应进行临床评估。

结果

在 3 个月(平均)内,使用平阳霉素进行了 3.2 次(平均)经皮硬化治疗。所有病变的显著改善率为 90.0%。所有毛细血管畸形伴结节性改变和淋巴管畸形的病变均显著改善,静脉畸形的病变中有 82.4%显著改善。7 名患者(23.3%)出现了疼痛和头痛等不良反应。所有不良反应均在 24 小时内发生,且均可耐受。

结论

经皮平阳霉素硬化治疗通过经皮途径治疗血管畸形是有效且可耐受的。因此,皮肤科医生可以有效地将其应用于血管畸形的治疗。

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