Klippel-Trenaunay综合征的微创治疗

目的总结血管内介入、激光光凝、硬化剂注射等微创技术治疗Klippel-Trenaunay综合征(Klippel-Trenaunay syndrome,K-TS)的临床经验. 方法 1989年2月～2004年11月我院收治32例K-TS,对深部异常的动静脉瘘和下肢异常的动脉侧枝进行栓塞治疗,对功能不全的深静脉瓣膜进行微创修复,对粗大的曲张静脉行激光光凝治疗,对肢体血管瘤和局限性迂曲成团的细小静脉丛注射硬化剂. 结果 32例随访1～7年,平均5年,未见复发.29例肢体曲张静脉包括网状静脉扩张完全消失,造影检查动静脉瘘当即消失,股骨异常血液供应消失.32例肢体增粗现象逐渐减轻.32例血管瘤于注射后2～3个月完全硬化、消失或明显减小但无按压缩小现象.7例瓣膜修复者多普勒检查股浅静脉无明显返流. 结论血管内介入、血管内激光光凝、硬化剂注射、小切口瓣膜修复等综合治疗K-TS可取得较好的疗效,值得推广应用.

Minimally invasive treatment for Klippel-Trenaunay syndrome

Objective To summarize the clinical experience of minimally invasive treatment (sclerosing therapy, intravascular intervention, laser coagulation, etc) for Klippel-Trenaunay syndrome (K-TS). Methods A total of 32 patients with K-TS were treated in this hospital from February 1989 to November 2004. Vascular embolization was used in patients with abnormal arteriovenous fistula or abnormal collateral arterial pathway. The insufficient valves of the deep veins were minimally invasively repaired. Laser coagulation was utilized for treating bulky varicosities. For angiomas and engorged venous plexus of the limbs, the sclerosing agent was injected. Results Varicosis, including reticular venous dilation, subsided completely. Angiography revealed an immediate disappearance of arteriovenous fistula and abnormal blood supply of the femur. The enlargement of involved limbs was diminished gradually. The angioma became completely sclerous, disappeared or decreased in size, without dwindling under pressure. In patients with venous valve reconstruction, Doppler ultrasonography showed no reflux. Follow-up for 1~7 years (mean, years) in all the 32 patients found no recurrence. Conclusions Minimally invasive treatment, including intravascular intervention, laser coagulation, sclerosing agent injection, mini-incision valve repair and so on, is effective for the management of Klippel-Trenaunay syndrome.