周围静脉畸形281例手术治疗分析

目的：分析周围静脉畸形的手术治疗经验。方法：1996年12月至2004年4月共手术治疗周围静脉畸形28l例。根据临床观察及磁共振(MRI)检查结果分为局限性非浸润型、局限性浸润型、弥漫性非浸润型及弥漫性浸润型等4型，按不同分类，采用不同的手术方式，如病变切除术、病变手术翻瓣联合Nd：YAG激光治疗术及病变手术切除联合Nd：YAG激光治疗术。结果：经随访3月～7．5年，局限性非浸润型总有效率为98．1％。复发率为1．9％。并发症发生率为1．9％，而弥漫性浸润型总有效率为85．2％，复发率为14．9％，并发症发生率为21．0％。结论：静脉畸形的治疗仍是临床难题之一，根据病变分类采用不同的手术方式是必要的，对于弥漫性病变，手术联合Nd：YAG激光治疗术是一种安全、有效、并发症少的新术式。

Analysis of results of surgical treatment in 281 patients with peripheral venous malformations

Objective To analyze the results of surgical treatment of peripheral venous malformations. Methods A total of 281 patients with peripheral venous malformations were operated upon from December 1996 to April 2004.According to clinical observation and examination by magnetic resonance imaging(MRI), the peripheral venous malformations were divided into 4 types: the localized form without invasion, the localized form with invasion, the diffuse form without invasion, and the diffuse form with invasion. Appropriate methods of surgical treatment were applied to different types of lesions, such as surgical resection, continuous Nd:YAG laser irradiation after surgical exposure, and surgical resection combined with continuous Nd:YAG laser irradiation. Results After a follow-up of 3 months to 7.5 years, the overall rate of effective surgical treatment in the localized form without invasion was 98.1%, and the incidence of recurrence was 1.9%, and the incidence of complications was 1.9%. By contrast, the overall rate of effective surgical treatment in the diffuse form with invasion was 85.2%, and the incidence of recurrence was 14.9%, and the incidence of complications was 21.0%. Conclusions Venous malformations are still difficult to treat effectively. Appropriate methods of surgical treatment should be individualized for different types of lesions. For the diffuse form, surgical procedure combined with continuous Nd:YAG laser irradiation is a safe and effective method with low incidemce of complications.