无水酒精硬化治疗头颈部动静脉畸形

目的 探讨无水酒精硬化治疗头颈部动静脉畸形的疗效及安全性.方法 回顾性分析西安交通大学第二附属医院2014年1月年至2016年6月21例头颈部动静脉畸形行无水酒精硬化治疗患者的临床随访资料, 其中男性12例, 女性9例, 年龄559岁, 平均19岁.根据症状和体征的临床反应和动脉造影或增强CT病变血流的消除程度来评估治疗效果.详细记录治疗并发症.结果 治愈6例 (29%) , 好转12例 (57%) , 无效2例 (10%) , 进展0例, 失访1例 (5%) .7例 (33%) 患者出现一种或多种并发症, 皮肤坏死5例 (24%) , 张力性水泡3例 (14%) , 周围神经损伤3例 (14%) .所有并发症3月内康复.未出现不可逆组织坏死和永久性功能损害.结论 无水酒精硬化为头颈部动静脉畸形有效的治疗方法, 但存在潜在的严重并发症的风险, 每1次治疗前应进行多学科系统的评估和制定详细的治疗计划.

Clinical Research of Absolute Ethanol Sclerotherapy for Arteriovenous Malformations in the Head and Neck

Objective To evaluate the therapeutic efficacy and safety of absolute ethanol sclerotherapy for arteriovenous malformations in the head and neck. Me thods We made a retrospective analysis of 21 patients (12 male, 9 female, age range 5 59 years; mean age 19 years) with arteriovenous malformations who underwent absolute ethanol sclerotherapy in the second affiliated hospital of Xa'an Jiautong University between January 2014 and June 2016. Therapeutic outcomes were evaluated by clinical responses of symptoms and signs, as well as the degree of devascularization on angiography or contrast-enhanced computed tomography. Treatment complications were recorded detailedly. Re s ults Six patients (29%) were cured, 12 patients (57%) improved, and 2 patients (10%) had no change and no patient showed aggravation after treatment. One patient was lost to follow-up and 7 patients (33%) had one or more complications, including skin necrosis in 5 patients (24%) , (24%) , tension blisters in 3 patients (14%) and peripheral nerve injury in 3 patients (14%) . All of the complications were recovered in 3 months. There was no irreversible necrosis and permanent impairment of function. Conclus ion Absolute ethanol sclerotherapy embolotherapy is an effective treatment for head and neck arteriovenous malformations, but it carries a potential risk of serious complications, so systemic disciplinary careful evaluation and detailed treatment plan must be required before each therapy.