肌肉内静脉畸形硬化治疗后肢体挛缩的预防策略探讨

目的:探讨硬化剂注射治疗肌肉内或关节区静脉畸形后继发肢体挛缩的康复预防策略。方法:针对静脉畸形硬化治疗后易发生肢体挛缩的部位,制定预防性抗挛缩训练方案。对于病变位于肌肉内或关节附近的患者,预防性进行抗挛缩训练,观察硬化治疗后相关肢体挛缩发生情况。结果:本组163例患者参与预防性抗挛缩训练,其中涉及肩、肘、腕、掌指、髋、膝、踝等关节,训练自硬化治疗后3d开始并维持至术后3~6个月,平均随访10.4个月,期间出现1例(0.6%)肩关节外旋位外展上举功能受限患者,随后通过加强功能训练后症状缓解。结论:预防性抗肢体挛缩训练可以有效预防硬化剂注射治疗静脉畸形可能带来的肢体挛缩并发症的发生。

Prevention Strategy of Limb Contracture after Sclerotherapy of Intramuscular Venous Malformation

Objective To explore the rehabilitative prevention strategies of limb contracture secondary to the sclerotherapy of intramuscular or periarticular venous malformation.Methods As for the limb parts prone to contracture after the sclerotherapy of venous malformations,the preventive anti-contracture training program was formulated.And for the patients with venous malformations in muscles or near joints,the anti-contracture training was conducted to reveal the occurrence of limb contracture after sclerotherapy.Results 163 patients received preventive anti-contracture training,including joints of shoulder,elbow,wrist,palm and fingers,hip,knee,and ankle.The anti-contracture training was started 3 days post-sclerotherapy and lasted for 3 to 6 months.The average follow-up time was 10.4 months.Only one patient (0.6%) got limited abduction and uplift of shoulder with external rotation,and the symptom was relieved by lasting functional training.Conclusion The preventive anti-contracture training can effectively prevent the possible complication of limb contracture caused by sclerotherapy for venous malformations.