头皮血管畸形的外科治疗（附12例报告）

目的探讨头皮血管畸形的外科治疗方法及效果。方法12例头皮血管畸形均经显微手术全切除。畸形血管团直径5cm以下者3例，5～10cm者5例，10cm以上者4例。结果病理检查证实海绵状血管畸形3例，动静脉畸形9例。12例在随访期内（随访6个月至8年）均获痊愈，未见复发。结论手术全切除治疗头皮血管畸形最为彻底，应作为首选。采用头皮皮瓣，手术中仔细辨认头皮的正常血管和畸形的供血血管，分离暴露畸形的供血血管后结扎离断，待畸形血管团萎陷后，将畸形从皮下组织中完整分离切除，分离过程中保留完整的真皮层，是减少手术失血和防止术后头皮缺损的重要方法。对于骨膜中异常增多增粗的血管和累及颞肌的血管，应彻底切除，防止术后复发。

Microsurgery for Vascular Malformations on Scalps (a Report of 12 Cases)

Objective To explore surgical procedure to treat vascular malformations on scalps and its curative effect on them. Methods The vascular malformations were microsurgieally resected in 12 patients with vascular malformations on the scalps, of which, masses had the diameters of less than 5 cm in 3 patients, 5 to 10 cm in 5 and more than 10 cm in 4. Results The postoperative pathological examination showed that of 12 cases of the vascular malformations, 3 were cavernous hemangioma and 9 arteriovenous malformations. The vascular malformations were totally resected in all the patients, in whom no vascular malformations recurred during the following-up from 6 months to 8 years. Conclusions Surgical excision is the most effective method to treat vascular malformation on the scalps. A wide scalp flap including uninvolved scalp arteries and ligation of the feeding artery near the nidus may reduce the loss of blood during the operation and prevent scalp necrosis. The lesions which invade the perieranium and temporal muscle should he completely excised to prevent the vascular malformations from recurrence.