Department of Radiology, Wuhan Children Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
Biomed Res Int. 2018 Oct 18;2018:3878960. doi: 10.1155/2018/3878960. eCollection 2018.
Management of LMs still remains a challenge especially for those suffering from complications such as acute airway compression. In this study, we retrospectively evaluated the efficacy and safety of percutaneous lauromacrogol foam sclerotherapy for the patients with acute airway compression caused by lymphatic malformations (LMs) in infants. Five cases of infants with acute airway compression caused by LMs were treated with lauromacrogol foam sclerotherapy in the radiology department from February 2013 to August 2015 at Wuhan Medical and Healthcare Center for Women and Children, China. By CT examination and the DSA imaging, LMs were diagnosed and progressed cervical and sublingual LMs combined with hemorrhages were observed and suppression of the trachea was noticed as well, resulting in the difficulty with breathing and feeding. For all the patients, we extracted most cyst liquid from the LMs to reduce the surface tension and alleviate the respiratory pressure symptoms under the guidance of ultrasound. Subsequently, the lauromacrogol foam was injected percutaneously into the cyst of LMs. The dose of the agent was determined according to the size of the LMs, which was 3-8 ml in our study. After treatment, autonomous respiration and independent eating were observed. When the procedures were completed after 16 cycles, the cyst cavity became atrophic and then nearly vanished. During the follow-up period (a minimum of three months and a maximum of two years), 4 patients were clinically proved to be cured and one patient was significantly improved. There was no recurrence, serious complications, or adverse reactions. Our study demonstrated that percutaneous sclerotherapy combined with lauromacrogol foam is a safe, effective therapy for acute airway compression caused by LMs, especially giving a good cosmetic result.
淋巴管瘤（LMs）的管理仍然是一个挑战，尤其是对于那些患有急性气道压迫等并发症的患者。在本研究中，我们回顾性评估了经皮聚桂醇泡沫硬化疗法治疗婴儿淋巴畸形（LMs）引起的急性气道压迫的疗效和安全性。2013 年 2 月至 2015 年 8 月，中国武汉妇女儿童医疗保健中心放射科对 5 例因 LMs 引起急性气道压迫的婴儿进行了聚桂醇泡沫硬化疗法治疗。通过 CT 检查和 DSA 成像，诊断为 LMs，并观察到进展性颈和舌下 LMs 合并出血，并发现气管受压，导致呼吸困难和喂养困难。对于所有患者，我们在超声引导下从 LMs 中抽出大部分囊液，以降低表面张力，缓解呼吸压力症状。随后，将聚桂醇泡沫经皮注入 LMs 囊内。根据 LMs 的大小确定药物剂量，本研究中为 3-8ml。治疗后，观察到自主呼吸和独立进食。16 个周期后，囊腔萎缩，几乎消失。在随访期间（最短 3 个月，最长 2 年），4 例患者临床治愈，1 例患者明显改善。无复发、严重并发症或不良反应。我们的研究表明，经皮硬化治疗联合聚桂醇泡沫是治疗 LMs 引起的急性气道压迫的一种安全、有效的方法，特别是能获得良好的美容效果。
