聚桂醇泡沫硬化剂治疗静脉畸形的高效技术：中期结果。
Interim results of bleomycin-polidocanol foam sclerotherapy as a highly efficient technique for venous malformations.
机构信息
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
J Vasc Surg Venous Lymphat Disord. 2020 Nov;8(6):1066-1073. doi: 10.1016/j.jvsv.2019.11.022. Epub 2020 Apr 10.
OBJECTIVE
The objective of this study was to retrospectively review the clinical and radiographic outcomes of patients with venous malformations (VMs) treated with bleomycin-polidocanol foam (BPF) sclerotherapy.
METHODS
The Institutional Review Board waived ethical approval for this retrospective review in which 55 patients (31 female and 24 male patients; mean age, 18.8 years; range, 2-60 years) were treated with BPF sclerotherapy. The stability (half-life) of BPF compared with polidocanol foam was studied. Standard sclerotherapy techniques were used. A total of 111 sclerotherapy sessions were performed, with a mean of 2.0 treatments per patient (range, 1-6). An average of 10 mL of BPF was used per procedure, with the total amount ranging from 2.5 to 30 mL. Symptoms before and after treatment, follow-up time, complications, and volume reduction on magnetic resonance imaging were recorded.
RESULTS
The median half-lives of the BPF and polidocanol foam were 238.25 ± 3.86 seconds and 194.33 ± 3.5 seconds, respectively. A t-test indicated significant differences between the groups (P < .01). The mean follow-up was 14 months (range, 6-24 months). All 55 patients (100%) reported improvement in symptoms. The total excellent and good response rate was 94.6%. An excellent response was achieved in 32 cases (58.2% [32/55]), a good response in 20 cases (36.4% [20/55]), and a poor response in 3 cases (5.4% [3/55]). Postprocedural magnetic resonance imaging demonstrated volume reduction of treated lesions in 54 of 55 patients (98%), with a mean lesion volume reduction of 84.6%. Postprocedure complications were minor in 13 of 111 procedures (12%) that were performed on 10 of 55 patients (18.2%), and no major complications occurred.
CONCLUSIONS
BPF sclerotherapy of VMs is safe and effective. BPF sclerotherapy can be a promising first-line treatment of VMs.
目的
本研究旨在回顾性分析采用平阳霉素聚桂醇泡沫（BPF）硬化治疗的静脉畸形（VM）患者的临床和影像学结果。
方法
本回顾性研究经机构审查委员会批准豁免伦理审查，共纳入 55 例患者（31 例女性，24 例男性；平均年龄 18.8 岁；年龄范围 2-60 岁），均接受 BPF 硬化治疗。研究比较了 BPF 与聚桂醇泡沫的稳定性（半衰期）。采用标准的硬化治疗技术。共进行了 111 次硬化治疗，平均每位患者进行 2.0 次治疗（范围 1-6 次）。每次治疗平均使用 10ml 的 BPF，总量为 2.5-30ml。记录治疗前后的症状、随访时间、并发症以及磁共振成像上的体积减少情况。
结果
BPF 和聚桂醇泡沫的半衰期中位数分别为 238.25±3.86 秒和 194.33±3.5 秒，t 检验结果显示两组间存在显著差异（P<.01）。平均随访时间为 14 个月（范围 6-24 个月）。55 例患者（100%）均报告症状改善。总优良反应率为 94.6%。32 例（58.2%[32/55]）患者获得优效反应，20 例（36.4%[20/55]）患者获得良效反应，3 例（5.4%[3/55]）患者获得差效反应。55 例患者中有 54 例（98%）的治疗后磁共振成像显示病变体积缩小，平均病变体积缩小 84.6%。111 次治疗中有 13 次（12%）发生轻微并发症，10 例患者（18.2%）出现 10 次并发症，无严重并发症发生。
结论
BPF 硬化治疗 VM 安全有效。BPF 硬化治疗可能是 VM 的一种有前途的一线治疗方法。
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