Fang M R, Wang L, Li T T, Deng X W, Li X Y, Lu M
School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China Ultrasound Medical Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu 610041, China.
Ultrasound Medical Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu 610041, China.
Zhonghua Yi Xue Za Zhi. 2025 Apr 22;105(16):1256-1261. doi: 10.3760/cma.j.cn112137-20241116-02571.
To compare the efficacy of ultrasound-guided microwave ablation and sclerosing agents in the treatment of head and neck venous malformations. Patients with head and neck venous malformations treated by ultrasound guidance at Sichuan Cancer Hospital were retrospectively enrolled from August 2019 to May 2024. The patients were divided into the ablation group and the sclerotherapy group according to different treatment methods, and the lesion volume reduction rate (VRR), efficacy evaluation, number of treatments, cosmetic grading score (CGS), pain numerical rating scale (NRS), patient satisfaction and postoperative complications were compared between the two groups before the surgery and at the last follow-up after the surgery. Follow-up was conducted every 3 months after surgery until there was no significant change in the lesion for half a year and the patient had no other discomfort. A total of 76 patients including 20 males and 56 females were enrolled, with a mean age of (35.4±17.6) years. There were 34 patients (11 males and 23 females) in the ablation group, with a mean age of (36.6±18.3) years and 37 lesions. Fourty-two patients (9 males and 33 females) were in the sclerotherapy group, with a mean age of (34.4±17.2) years and 45 lesions. The follow-up time of the ablation group and sclerotherapy group was (12.3±0.7) months and (12.0±0.5) months, respectively. The number of treatments in the ablation group was less than that in the sclerotherapy group [(1.1±0.2) vs (3.1±1.0), <0.05]. There were no significant differences in VRR, efficacy evaluation, CGS score, NRS score, and satisfaction score between the two groups (all >0.05). The volume of lesions in both the ablation group and the sclerotherapy group was reduced at the last follow-up after the surgery compared with that before the surgery [ablation group: 3.7 (1.6, 15.2) vs 0.7 (0.2, 2.5) cm, sclerotherapy group: 5.3 (0.6, 11.0) vs 0.5 (0.1, 3.3) cm], and the CGS score and NRS score were lower than those before surgery [ ablation group: (3.9±0.3) vs (1.4±0.7), (4.9±0.8) vs (1.1±0.9), sclerotherapy group: (3.9±0.3) vs (1.2±0.5), (5.0±0.7) vs (1.2±1.0)] (all <0.05). None of the patients in either group developed serious complications. Ultrasound-guided microwave ablation is safe and effective in the treatment of head and neck venous malformations, and can reduce the number of treatments compared with conventional sclerotherapy.
比较超声引导下微波消融与硬化剂治疗头颈部静脉畸形的疗效。回顾性纳入2019年8月至2024年5月在四川省肿瘤医院接受超声引导治疗的头颈部静脉畸形患者。根据不同治疗方法将患者分为消融组和硬化治疗组，比较两组手术前及术后最后一次随访时的病变体积缩小率（VRR）、疗效评估、治疗次数、美容分级评分（CGS）、疼痛数字评分量表（NRS）、患者满意度及术后并发症。术后每3个月进行随访，直至病变半年内无明显变化且患者无其他不适。共纳入76例患者，其中男性20例，女性56例，平均年龄（35.4±17.6）岁。消融组34例患者（男性11例，女性23例），平均年龄（36.6±18.3）岁，有37个病变；硬化治疗组42例患者（男性9例，女性33例），平均年龄（34.4±17.2）岁，有45个病变。消融组和硬化治疗组的随访时间分别为（12.3±0.7）个月和（12.0±0.5）个月。消融组的治疗次数少于硬化治疗组[（1.1±0.2）次 vs （3.1±1.0）次，<0.05]。两组在VRR、疗效评估、CGS评分、NRS评分及满意度评分方面均无显著差异（均>0.05）。与手术前相比，消融组和硬化治疗组在术后最后一次随访时病变体积均减小[消融组：3.7（1.6，15.2）cm vs 0.7（0.2，2.5）cm，硬化治疗组：5.3（0.6，11.0）cm vs 0.5（0.1，3.3）cm]，且CGS评分和NRS评分均低于手术前[消融组：（3.9±0.3）分 vs （1.4±0.7）分，（4.9±0.8）分 vs （1.1±0.9）分，硬化治疗组：（3.9±0.3）分 vs （1.2±0.5）分，（5.0±0.7）分 vs （1.2±1.0）分]（均<0.05）。两组患者均未发生严重并发症。超声引导下微波消融治疗头颈部静脉畸形安全有效，与传统硬化治疗相比可减少治疗次数。
