无水乙醇联合泡沫硬化剂治疗直肠静脉畸形效果和安全性分析

【摘要】　目的?探讨无水乙醇联合泡沫硬化剂治疗直肠静脉畸形（VM）的安全性和有效性。 方法?回顾性分析2017年10月至2018年5月收治的5例出血性直肠VM患儿，根据Puig分型选择经皮硬化治疗。术后随访观察有效性、不良反应和并发症。结果?5例患儿均为PuigⅡ、Ⅲ型，接受无水乙醇联合泡沫硬化剂治疗共10次（1～3次）。无水乙醇单次应用平均剂量（0.11±0.05）mL/kg，3%聚多卡醇单次应用平均剂量（2.35±0.94） mL。术后2例治愈，2例基本治愈，1例有效，有效率为100%。随访12～18个月，患儿未再有便秘或出血情况，无皮肤坏死或严重心肺系统并发症。结论?根据Puig分型采用无水乙醇联用泡沫硬化剂治疗直肠VM，可降低无水乙醇用量，提高治疗安全性，增加疗效。

Injection of ethanol combined with foam hardening agent for the treatment of rectal venous malformation:analysis of curative effect and safety

Objective To investigate the safety and efficacy of injection of ethanol plus foam hardening agent in the treatment of rectal venous malformation.Methods The clinical data of 5 sick children with hemorrhagic rectal venous malformation(VM),who were admitted to authors’hospital during the period from October 2017 to May 2018 to receive treatment,were retrospectively analyzed.According to Puig’s classification,percutaneous sclerotherapy was selected.Postoperative follow-up observation was conducted,and curative effect,adverse reactions and complications were recorded.Results All the 5 sick children were suffered from VM of Puig typeⅡor typeⅢ.A total of 10 times of percutaneous sclerotherapy with ethanol plus foam hardening agent were performed in 5 sick children.The single average dose of ethanol was(0.11±0.05)mL/kg,and the single average dose of 3%polidocanol was(2.35±0.94)mL.After the treatment,2 patients were cured,2 patients were basically cured,and one patient showed effective response.The effective rate was 100%.The sick children were followed up for 12-18 months.The children no longer had constipation or bleeding,and no skin necrosis or severe cardiopulmonary complications occurred.Conclusion Based on Puig’s classification,percutaneous sclerotherapy with ethanol plus foam hardening agent is an effective treatment for rectal VM,it can reduce the dose of ethanol as well as improve the treatment safety and the curative effect.