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静脉畸形硬化治疗后局部血管内凝血相关指标变化的长期随访研究

A long-term follow-up study of the changes in localized intravascular coagulation-related indexes after sclerotherapy of venous malformation.

作者信息

Zheng Miao, Zhong Hai-Yan, Sun Yi-Ran, Zou Ming-Li, Chen Yong-Pei, Yuan Si-Ming

机构信息

Department of Plastic Surgery, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.

Department of Plastic Surgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China.

出版信息

Phlebology. 2025 Jun;40(5):345-352. doi: 10.1177/02683555241308086. Epub 2024 Dec 10.

Abstract

ObjectiveLocalized intravascular coagulation (LIC) is a unique phenomenon associated with venous malformations (VMs). This study investigated the changes in LIC related indexes following sclerotherapy of VMs and its correlation with therapeutic efficacy.MethodsFrom August 2019 to September 2023, patients who met the following criteria were enrolled into this study: (1) individuals with venous malformations accompanied by LIC; (2) those who had undergone a minimum of three sclerotherapy sessions; (3) blood coagulation function tests were conducted prior to each treatment; and (4) magnetic resonance imaging (MRI) scans were conducted both before and after three times of treatment. Those who fail to meet with the previous inclusion criteria were excluded. The coagulation profile prior to each sclerotherapy treatments was assessed. The therapeutic outcomes were evaluated at the end of treatment.ResultsA total of 21 patients were enrolled into the study, with the age ranging from 4 to 61 years old. Elevated D-dimer levels, with or without a decrease in fibrinogen (FIB) and an increase in fibrin degradation products (FDP) are clinical features of VMs with LIC. The coagulation indexes tend to settle down with several sclerotherapy treatments. There were 5 cases in the significantly improved group, 13 cases in the improved group, and 3 cases in the no improved group when it came to efficacy assessment. The better therapeutic efficacy is more pronounced the improvement of LIC.ConclusionsLIC gradually returns to normal during sclerotherapy, and the degree of recovery is directly related to the treatment's efficacy. One useful metric to evaluate the effectiveness of sclerotherapy for VMs is the improvement of LIC.

摘要

目的

局限性血管内凝血(LIC)是一种与静脉畸形(VM)相关的独特现象。本研究调查了VM硬化治疗后LIC相关指标的变化及其与治疗效果的相关性。

方法

2019年8月至2023年9月,纳入符合以下标准的患者:(1)伴有LIC的静脉畸形患者;(2)至少接受过3次硬化治疗的患者;(3)每次治疗前进行凝血功能检查;(4)3次治疗前后均进行磁共振成像(MRI)扫描。不符合上述纳入标准的患者被排除。评估每次硬化治疗前的凝血情况。在治疗结束时评估治疗效果。

结果

共纳入21例患者,年龄4至61岁。D-二聚体水平升高,伴有或不伴有纤维蛋白原(FIB)降低及纤维蛋白降解产物(FDP)升高是LIC型VM的临床特征。经过几次硬化治疗后,凝血指标趋于稳定。疗效评估时,显著改善组5例,改善组13例,未改善组3例。LIC改善越明显,治疗效果越好。

结论

硬化治疗期间LIC逐渐恢复正常,恢复程度与治疗效果直接相关。LIC的改善是评估VM硬化治疗效果的一个有用指标。

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