介入栓塞术在耳廓巨大血管瘤手术中的临床价值

目的探讨数字减影成像显影下介入栓塞术在耳廓巨大血管瘤手术中的临床疗效及应用价值。方法回顾分析近3年来5例耳廓巨大血管瘤患者,术前行DSA血管造影判断责任血管并行介入栓塞治疗,观察栓塞后肿瘤形态、术中出血、伤口愈合及并发症情况。结果5例耳廓巨大血管瘤患者术前对责任血管栓塞后瘤体明显缩小、颜色变暗,48 h内行手术治疗,术中出血平均约100 ml,伤口一期愈合,无术后出血及偏瘫等并发症。结论耳廓巨大血管瘤术前辅助介入栓塞治疗后可明显减少术中出血、缩短手术时间,提高手术成功率。     

介入栓塞治疗肝血管瘤

目的 探讨介入栓塞治疗肝血管瘤的疗效。方法 收集18例经CDFI、MSCT、MRI及DSA确诊的肝血管瘤患者,采用Seldinger技术穿刺右股动脉,超选择至肿瘤供血动脉,以超液态碘油或平阳霉素超液态碘油乳剂,或联合明胶海绵颗粒和（或）明胶海绵条栓塞肿瘤血管。术后随访评价栓塞治疗疗效。结果 栓塞治疗术后患者临床症状均消失;血管瘤随时间延长而逐渐缩小,栓塞前血管瘤最大径为（10.20±3.24）cm,栓塞后血管瘤保持稳定时最大径为（4.44±2.16）cm,治疗前后差异有统计学意义（P<0.05）;介入栓塞治疗有效率为100%,无严重并发症发生。结论 介入栓塞治疗肝血管瘤创伤小、疗效可靠、并发症少,可作为肝血管瘤首选治疗方法。     

平阳霉素碘化油乳剂介入治疗肝血管瘤疗效观察

目的 探讨平阳霉素碘化油混合乳剂动脉栓塞在肝血管瘤介入治疗中的临床疗效.方法 利用平阳霉素碘化油混合乳剂,对36例肝血管瘤患者进行动脉栓塞治疗,术后1～8个月观察肿瘤大小变化及并发症.结果 肝血管瘤缩小＞50%者16例,肿瘤缩小＞30%者14例,肿瘤缩小＞10%者6例.结论 平阳霉素碘化油混合乳剂动脉栓塞治疗肝血管瘤是一种疗效确切、安全理想的治疗方法.     

介入栓塞治疗肝癌破裂出血的临床效果

目的:分析肝癌破裂出血采用介入栓塞治疗的临床疗效。方法:选取2014年9月~2016年9月我院收治的50例接受介入栓塞治疗的肝癌破裂出血患者为研究对象。分析患者治疗临床效果。结果:治疗后,患者止血成功率为100%,术中出现失血性休克1例,肝部肿瘤均发生缩小或坏死。结论:介入栓塞治疗肝癌破裂性出血,可有效控制出血,使肿瘤部位缩小或坏死,值得临床推广应用。     

12例鼻咽纤维血管瘤的术前栓塞治疗临床分析

目的对鼻咽纤维血管瘤术前栓塞的疗效及并发症进行评价。方法回顾性分析2002年11月至2006年11月以来经手术及病理证实的鼻咽纤维血管瘤患者12例,12例鼻咽纤维血管瘤手术前1～3d行超选择供血动脉栓塞,详细观察栓塞后毒副作用及并发症,并记录手术时出血量。结果血管造影可清晰显示肿瘤病变范围及供血情况,12例患者中一侧颌内动脉供血8例,合并咽升动脉供血4例。7例完全栓塞,5例仅部分栓塞。毒副作用为栓塞侧面部疼痛4例,无严重并发症发生。所有病变均完整切除。术中平均出血量为470ml。结论鼻咽纤维血管瘤术前栓塞能减少外科术中出血并提高肿瘤切除率。     

症状性肝血管瘤介入治疗56例分析

目的：评价平阳霉素碘油乳剂经选择性肝动脉栓塞治疗症状性肝血管瘤的临床应用和疗效。方法：对56例有症状的肝血管瘤患者行肝动脉插管注入平阳霉素碘油乳剂栓塞硬化肝血管瘤体,并用明胶海绵颗粒栓塞瘤体供血动脉。结果：栓塞治疗后肿瘤明显缩小,术后第1、3、6、12个月复查：肿瘤平均缩小39.7%、52.9%、75.0%、80.9%。所有患者栓塞治疗后临床症状明显减轻或消失,无严重并发症发生。结论：选择性肝动脉栓塞术治疗肝血管瘤安全、有效、并发症少,值得临床推广应用。     

介入法治疗8例颌面部血管瘤的护理

颌面部血管瘤因解剖部位和生理功能的特殊性 ,治疗较为棘手。近半年来 ,荧光屏监视导管选择性动脉栓塞术(ＴＣＡＥ)的临床应用 ,为该病治疗开辟了一条新的途径[1] 。我院应用放射介入栓塞术 ,结合平阳霉素腔内注射 ,治疗海绵和蔓状血管瘤 ,取得了良好的效果。1　临床资料1.1　一般资料　 8例患者中 ,颊面部血管瘤 6例 ,舌血管瘤 1例 ,唇血管瘤 1例。其中男性 6例 ,女性 2例 ,病程 1～ 12年。1.2　方法与结果　 8例患者介入栓塞后 ,均行平阳霉素腔内注射 ,每次 3～ 3.5ｍｇ ,1%的利多卡因溶解。经上述治疗后 ,7例瘤体明显缩小 ,随访半年无一…     

介入法治疗8例颌面部血管瘤的护理

颌面部血管瘤因解剖部位和生理功能的特殊性,治疗较为棘手.近半年来,荧光屏监视导管选择性动脉栓塞术(TCAE)的临床应用,为该病治疗开辟了一条新的途径[1].我院应用放射介入栓塞术,结合平阳霉素腔内注射,治疗海绵和蔓状血管瘤,取得了良好的效果. 1 临床资料1.1 一般资料 8例患者中,颊面部血管瘤6例,舌血管瘤1例,唇血管瘤1例.其中男性6例,女性2例,病程1～12年. 1.2 方法与结果 8例患者介入栓塞后,均行平阳霉素腔内注射,每次3～3.5 mg,1%的利多卡因溶解.经上述治疗后,7例瘤体明显缩小,随访半年无一例复发.     

肝动脉灌注化疗栓塞治疗肝癌168例围术期护理

目的:探讨肝动脉灌注化疗栓塞治疗肝癌患者的护理方法。方法:对168例实行经肝动脉导管介入化疗加栓塞治疗的肝癌患者给予术前、术中、术后护理。结果:168例患者经治疗后,肿瘤缩小,较少出现并发症。结论:护理工作在肝动脉灌注化学治疗和栓塞治疗中起重要作用。     

鼻咽纤维血管瘤手术前介入栓塞的临床应用

目的:探讨鼻咽纤维血管瘤术前介入栓塞的临床价值。方法:回顾分析17例鼻咽纤维血管瘤患者的临床资料,其中12例行数字减影动脉血管造影及栓塞,5例直接手术切除。供血动脉主要为颈外动脉的颌内或(和)咽升动脉,栓塞物为明胶海绵。结果:栓塞后10例(占83%)肿瘤血管血供完全消失,8例栓塞后瘤体缩小约2/5,栓塞后48～72h手术最理想。结论:鼻咽纤维血管瘤术前介入动脉栓塞是安全有效的治疗方法之一。     

Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study

Background: This prospective study evaluated the clinical and radiologic results of transcatheter arterial embolization (TAE) for the treatment of symptomatic cavernous hemangiomas of the liver. The technique, its complications, and effectiveness also were analyzed. Methods: Eight patients (five male, three female; mean age ± SD = 47.75 ± 8.59 years) with symptomatic cavernous hemangiomas of the liver were treated by TAE with polyvinyl alcohol particles or gelfoam and steel coils (single session) followed by supportive treatment. Tumor characterization (including the extent and number of lesions) was done on triple-phase helical computed tomography or gadolinium-enhanced dynamic magnetic resonance imaging. Results: The lesions were located in the right lobe in five patients, left lobe in one, and both lobes in two. The largest diameter of the lesions was 6–18 cm (9.28 ± 5.13 cm). The treatment response was assessed on follow-up ultrasound and color Doppler and/or contrast-enhanced helical computed tomography. There were no treatment-related deaths and morbidity was minimal. Embolization was the only method of treatment in seven patients; however, one patient had surgery after TAE because the symptoms were only partly relieved. Indications for embolization were abdominal pain (eight patients), rapid tumor enlargement (four of eight), and recurrent jaundice (one of eight). Symptomatic improvement was documented in all patients after embolization. Symptoms did not worsen in any patient. The mean size of the tumor did not show any statistically significant change on follow-up radiologic examinations. However, in one patient, the tumor significantly regressed in size after embolization. Conclusion: TAE of hepatic cavernous hemangioma is a useful procedure in the therapy of symptomatic hemangiomas. Received: 13 July 2000/Revision accepted: 27 December 2000     

栓塞治疗肝脏巨大海绵状血管瘤临床研究

目的 评价介入栓塞治疗肝脏巨大海绵状血管瘤的临床疗效。方法 对23例肝脏巨大海绵状血管瘤患者，用平阳霉素超液态碘油乳剂加明胶海绵颗粒行栓塞治疗，术后1mo、3mo、6mo超声随访瘤体变化情况。结果 23例患者的28个瘤体术后1mo、3mo、6mo复查，治疗有效瘤体个数分别为13(46．4％)、21(75％)、28(100％)，无复发病例。结论 平阳霉素超液态碘油乳剂加明胶海绵颗粒介入栓塞治疗肝脏巨大海绵状血管瘤疗效显著，有很好的临床应用价值。     

蔓状血管瘤的介入治疗

目的:评价介入方法对软组织蔓状血管瘤的治疗。方法:在DSA引导下对53例软组织蔓状血管瘤采取了血管内栓塞和?或经皮穿刺瘤内硬化介入治疗,其中四肢23例,躯干10例,头颈面部14例,五官(耳鼻)部6例。结果:所有病例的载瘤动脉及其远周畸形血管团得到全部或大部分闭塞、血管瘤局部肿胀减轻、震颤及杂音消失或减弱、溃破出血停止、囊性肿胀病灶变硬变小及固定。结论:介入治疗软组织蔓状血管瘤是一种有效的、创伤小的治疗方法,在目前情况下应作为首选的治疗方法。     

介入栓塞联合手术切除治疗儿童巨大头面部动静脉血管瘤的初步尝试

目的:尝试应用介入栓塞和手术切除联合方案治疗儿童巨大头面部动静脉血管瘤。方法:选择复旦大学附属儿科医院1例经介入联合手术治疗的巨大头面部动静脉血管瘤患儿,总结其相关诊疗经过及影像资料,分析其诊治方案的可行性。结果:成功切除患儿病灶,术中出血可控,术后伤口愈合良好,皮瓣活力正常,患儿容貌满意。结论:介入栓塞联合手术切除可能是儿童头面部动静脉血管瘤安全有效的治疗方式,合理的制定栓塞和手术方案是治疗成功的关键。     

Pulsed 1064-nm Nd:YAG laser therapy for noninvasive treatment of a massive hemangioma: case report

OBJECTIVE: The author determined whether cutaneous Nd:YAG laser therapy is a viable treatment option for a massive hemangioma located in the musculus soleus muscle of a patient's left leg. SUMMARY BACKGROUND DATA: Giant hemangiomas generally require aggressive medical or surgical therapy to address complications. Because of the size of the lesions, there are risks inherent with conventional treatment options. In selected patients, Nd:YAG laser therapy is a noninvasive approach to treating large, subcutaneous hemangiomas. METHODS: A 59-year-old female patient, who was diagnosed with a large, venous-type hemangioma in the musculus soleus muscle of the left leg, was treated during two treatment sessions with Nd:YAG laser therapy. A Plexiglas ring was placed on the leg, over the hemangioma, to force the hemangioma closer to the surface and laser irradiation was applied to the skin. RESULTS: At 6-month follow-up after the second treatment, magnetic resonance imaging (MRI) demonstrated 75%-80% reduction in lesion size. There were no permanent adverse effects encountered with the treatment method. CONCLUSIONS: The author concludes that in carefully selected cases Nd:YAG laser therapy can be used to treat large hemangiomas whose size poses risks with surgical and other treatments.     

平阳霉素碘油乳剂治疗肝血管瘤的疗效评价

目的评价平阳霉素碘油乳剂肝动脉栓塞治疗对肝血管瘤的临床疗效。方法将43例肝血管瘤患者随机分为对照组21例和观察组22例。对照组选用超液态碘化油5～20ml与适量造影剂混合制成碘化油乳剂进行栓塞治疗;观察组将平阳霉素8～24mg溶于2％的利多卡因3～5ml中,然后与碘化油5—20ml充分混合制成碘化油乳剂进行栓塞治疗。结果本组43例患者共行栓塞治疗52次,其中7例在2个月后行第二次栓塞（包括4例无效患者）,1例在2～5个月内行第三次栓塞。术后2—6个月复查B超、CT或行肝动脉造影,除3例无效患者外,其余患者肿瘤均有不同程度的缩小。观察组治疗效果明显优于对照组,结果经z。检验,差异有统计学意义（P〈0．05）。结论平阳霉素碘油乳剂动脉栓塞对肝血管瘤疗效较好,安全可靠,副反应小,可作为首选治疗方法。     

个体化32P敷贴及介入治疗皮肤血管瘤的疗效观察及护理

目的 探讨选用个体化放射性核素32P敷贴及介入治疗皮肤血管瘤的疗效及其护理在治疗中的作用.方法 选取2004年12月至2009年4月诊治的皮肤血管瘤患者734例,应用个体化治疗方案及护理措施:按1 Gy·cm-2·d-1制备敷贴器,介入治疗按6.8～10.0μCi/cm2决定投药量,根据血管瘤的生长部位、患者年龄决定投放32P放射剂量,治疗间隔1.5～2.0个月.护理措施:进行有效沟通,解除顾虑,建立治疗信心;应用数码相机在治疗前后对病变处拍照,并行计算机存档后制成单人合并图,客观评价治疗效果;发放健康教育处方,提供书面指导;电话回访,接受咨询,提供指导,了解疗效.结果 734例患者治愈率78.88%,总有效率94.14%,单纯性血管瘤治疗效果最好,年龄与治疗效果呈负相关.针对性的护理使不良反应发生率明显减少.结论 应用个体化32P敷贴及介入治疗皮肤血管瘤疗效满意,在临床工作中应严格掌握32P的投药量,护理工作对提高治疗效果、减少不良反应发生起到了关键作用.     

Early- and intermediate-term outcome of transarterial embolization for symptomatic hepatic focal nodular hyperplasia

Purpose: To evaluate the early- and intermediate-term outcome in patients with symptomatic hepatic focal nodular hyperplasia (FNH) treated with transarterial embolization using bleomycin-iodinated oil and polyvinyl alcohol (PVA) particles.Materials and methods: In this two-center retrospective study between January 2005 and December 2013, 27 consecutive patients with symptomatic hepatic FNH underwent superselective catheterization by microcatheter techniques and embolization using bleomycin-iodinated oil combined with PVA. Early-term (3–41 months) follow-up of TAE was performed in terms of symptom control, changes in lesion size, and complications. Intermediate-term (45–112 months) follow-up was carried out to assess symptom control and reinterventions for recurrence.Results: Embolization was performed in 27 patients with 31 lesions. Technical success was achieved in all cases. The follow-up period ranged from three to 112 months. At early-term follow-up, mean lesion diameters were decreased significantly from 6.4±2.7 cm pre-intervention to 3.6±1.8 cm at 3-9 months after embolization (P<0.001). A total of 7 lesions had complete resolution during the whole follow-up period. At intermediate-term follow-up, local recurrence was found in 1 treated lesion at 54-months. Contrast-enhanced scans showed complete lack of residual arterial blood supply in the majority of lesions during the follow-up period. There was no major complication associated with the procedure.Conclusion: Transarterial embolization using bleomycin-iodinated oil and PVA is a feasible, safe and effective alternative in both early- and intermediate-terms for the treatment of symptomatic hepatic FNH.     

心脏血管瘤临床病理特征分析

目的 探讨原发心脏血管瘤的临床特征及病理形态特征。方法 回顾性收集2015年至2021年原发心脏血管瘤存档切片，整理相关病史资料、治疗经过，复习组织病理形态，并进行随访。结果 共获得23例原发心脏血管瘤病例资料。男性11例，女性12例。年龄17～71岁。单发病灶22例，多发病灶1例。来源于心腔内10例，心脏表面13例。肿瘤最大径为1.0～11.3 cm。组织形态上，海绵状成分为主的血管瘤18例，毛细血管瘤成分为主的4例，另有一些少见细胞形态和生长模式。病灶均完整手术切除，随访时间8～88个月，患者均存活、无复发。结论 心脏血管瘤以单发为主，起病隐匿，常伴有心包积液，预后较好。组织学以海绵状形态为主，可出现少见细胞形态，有潜在误诊的风险。