Department of Plastic Surgery, Chiba Rosai Hospital, Ichihara, Japan.
Department of Plastic Surgery, Wound Repair and Regeneration, Fukuoka University, School of Medicine, Fukuoka, Japan.
J Vasc Surg Venous Lymphat Disord. 2020 Mar;8(2):244-250. doi: 10.1016/j.jvsv.2019.03.008. Epub 2019 Aug 27.
Depending on the size and site of the venous malformation (VM), patients with VM often experience pain and swelling. VMs in the head and neck typically have lower pain rates due to complications than VMs in the limbs and trunk. We evaluated the heuristics on VM pain by statistically analyzing data of patients with VM from a multicenter database in Japan.
We collected data on age, sex, pain, lesion site, lesion depth, and lesion size for 2199 clinical cases with common VMs. We created categories for lesion depth and size and excluded multiple lesion cases that overlapped in these categories. Next, we constructed cross-tabulation tables to analyze the factors that contributed to pain. Finally, we evaluated the risk of pain in patients with VM by performing binomial logistic regression analysis based on age, sex, lesion site, lesion depth, and lesion size.
For patients with limb and trunk VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 79%, followed by the skin and subcutis, with an incidence of 43%. For patients with head and neck VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 28%, followed by the skin and subcutis, with an incidence of 11% (P < .01). For pain incidence by lesion size, pain most frequently occurred in lesions >10 cm (67%), followed by lesions between 5 cm and 10 cm (56%) and lesions <5 cm (29%).
Our study indicated a clear order of factors that contributed to pain: lesion site > lesion depth > lesion size. Age was also an important factor. Infants and children had low pain complication frequencies with limb and trunk VMs. As the patients aged, the pain frequency became higher, reaching 50% at almost 7 years of age.
根据静脉畸形（VM）的大小和部位，患者通常会出现疼痛和肿胀。由于并发症较少，头颈部的 VM 比四肢和躯干的 VM 的疼痛发生率低。我们通过对来自日本多中心数据库的 VM 患者数据进行统计学分析，评估了 VM 疼痛的规律。
我们收集了 2199 例常见 VM 患者的年龄、性别、疼痛、病变部位、病变深度和病变大小等数据。我们为病变深度和大小创建了类别，并排除了这些类别中重叠的多个病变病例。然后，我们构建了交叉表来分析导致疼痛的因素。最后，我们根据年龄、性别、病变部位、病变深度和病变大小，通过二项逻辑回归分析评估 VM 患者疼痛的风险。
对于四肢和躯干 VM 的患者，疼痛最常见的部位是肌肉、肌腱和骨骼，发生率为 79%，其次是皮肤和皮下组织，发生率为 43%。对于头颈部 VM 的患者，疼痛最常见的部位是肌肉、肌腱和骨骼，发生率为 28%，其次是皮肤和皮下组织，发生率为 11%（P<.01）。对于病变大小的疼痛发生率，病变>10cm 时疼痛最常见（67%），其次是病变在 5cm 到 10cm 之间（56%）和病变<5cm（29%）。
我们的研究表明，导致疼痛的因素有明显的顺序：病变部位>病变深度>病变大小。年龄也是一个重要因素。婴儿和儿童四肢和躯干 VM 的疼痛并发症频率较低。随着患者年龄的增长，疼痛频率逐渐升高，在近 7 岁时达到 50%。
