Hou Fang, Chen Jidong, Xia Meng, Ding Ke, Zeng Qiang, Liu Wenying
Department of Pediatric Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital.
Department of Pediatric Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China.
Medicine (Baltimore). 2020 Feb;99(9):e18839. doi: 10.1097/MD.0000000000018839.
This study reports our experience, the therapeutic outcomes and complications of percutaneous sclerotherapy (PS) with polidocanol to treat venous malformations (VMs) in children.A retrospective analysis was conducted of pediatric patients with VMs who underwent PS using polidocanol under continuous ultrasound (US) guidance between January 2015 and January 2018 at our department. Medical records were reviewed to record demographic information, lesion characteristics, treatment sessions, therapeutic outcomes and complications. χ analysis was employed to evaluate the effects of these characteristics on outcomes.Hundred treatment sessions were performed for lesions in 47 patients. The mean age of the patients was 4.1 ± 3.6 years (mean ± SD). The female to male ratio was almost 2:1 (female 32, male 15). The location of the VMs included the head and neck in 16 cases (34.0%), upper extremity in 11 cases (23.4%), lower extremity in 10 cases (21.3%), and trunk and perineum in 10 cases (21.3%). The majority of the lesions were focal in 36 cases (76.6%), while 11 (23.4%) were diffuse. Seventeen patients (36.2%) underwent single PS session, 14 patients (29.8%) underwent 2 sessions, 10 patients (21.3%) underwent 3 sessions and 6 patients (12.7%) underwent ≧4 sessions. The mean PS session per patient was 2.1 ± 1.1. The mean follow-up duration was 11.4 ± 7.6 months. After the last PS session, 8 patients (17.0%) had excellent outcomes, 27 (57.4%) had good outcomes, 10 (21.3%) had fair outcomes, and 2 (4.3%) had poor outcomes. Focal lesions were more likely to have good or excellent outcomes than diffuse lesions (χ = 4.522, P = .033). No other lesion characteristic significantly affected the outcomes (good or excellent outcomes), including lesion location (χ = 2.011, P = .570) or lesion size (χ = 1.045, P = .307). After the PS procedure, temporary local swelling occurred in 81 sessions (81.0%), local pain occurred in 15 sessions (15.0%), fever occurred in 27 (27.0%) sessions, and transient local numbness occurred in four sessions (4.0%).PS with polidocanol under the guidance of US appears to be safe and effective for the treatment of VMs in children, especially for focal lesions.
本研究报告了我们使用聚多卡醇进行经皮硬化疗法（PS）治疗儿童静脉畸形（VMs）的经验、治疗结果及并发症。对2015年1月至2018年1月在我科接受在连续超声（US）引导下使用聚多卡醇进行PS治疗的VMs儿科患者进行了回顾性分析。查阅病历以记录人口统计学信息、病变特征、治疗次数、治疗结果及并发症。采用χ分析评估这些特征对结果的影响。
对47例患者的病变进行了100次治疗。患者的平均年龄为4.1±3.6岁（平均值±标准差）。男女比例约为2:1（女性32例，男性15例）。VMs的位置包括头颈部16例（34.0%）、上肢11例（23.4%）、下肢10例（21.3%）以及躯干和会阴10例（21.3%）。大多数病变为局灶性，共36例（76.6%），而11例（23.4%）为弥漫性。17例患者（36.2%）接受了单次PS治疗，14例患者（29.8%）接受了2次治疗，10例患者（21.3%）接受了3次治疗，6例患者（12.7%）接受了≥4次治疗。每位患者的平均PS治疗次数为2.1±1.1次。平均随访时间为11.4±7.6个月。在最后一次PS治疗后，8例患者（17.0%）效果极佳，27例（57.4%）效果良好，10例（21.3%）效果尚可，2例（4.3%）效果较差。与弥漫性病变相比，局灶性病变更有可能获得良好或极佳的治疗效果（χ=4.522，P=0.033）。没有其他病变特征显著影响治疗结果（良好或极佳的结果），包括病变位置（χ=2.011，P=0.570）或病变大小（χ=1.045，P=0.307）。PS治疗后，81次治疗（81.0%）出现了暂时性局部肿胀，15次治疗（15.0%）出现了局部疼痛，27次治疗（27.0%）出现了发热，4次治疗（4.0%）出现了短暂性局部麻木。
在US引导下使用聚多卡醇进行PS治疗儿童VMs似乎是安全有效的，尤其是对于局灶性病变。
