介入治疗下颌骨动静脉畸形出血的疗效分析

目的探讨介入治疗下颌骨动静脉畸形出血的临床价值。方法回顾性分析2012年1月至2018年1月于郑州大学第一附属医院接受介入治疗的7例下颌骨动静脉畸形患者的临床资料。患者男3例、女4例,年龄8.0~13.0(10.6±1.7)岁。4例为突发大出血,3例为自发性反复渗血。3例经动、静脉途径行双介入栓塞治疗,4例单纯经动脉途径栓塞,栓塞材料为聚乙烯醇颗粒及弹簧圈,术后随访9~18个月观察其疗效。结果7例患者,4例急性大出血患者介入术后出血得到有效控制,3例慢性渗血者症状消失,所有患者随访期间未再复发出血;1例出现口腔感染、牙龈肿胀增生,经抗感染、清创术后得到有效控制。所有患者无严重并发症发生。结论介入治疗下颌骨动静脉畸形出血疗效确切、安全可行,值得临床推广应用。

Effect analysis of interventional therapy for hemorrhage of mandibular arteriovenous malformations

Objective To explore the therapeutic value of interventional methods for hemorrhage caused by mandibular arteriovenous malformations.Methods The clinical data of 7 patients(3 males and 4 females)with mandibular arteriovenous malformations treated by interventional therapy from January 2012 to January 2018 in the First Affiliated Hospital,Zhengzhou University were retrospectively analyzed.Of all patients,4 patients suffered from sudden massive hemorrhage and 3 patients suffered from spontaneous repeated bleeding.The age ranged from 8.0 to 13.0(10.6±1.7)years.Of the 7 patients,3 underwent interventional embolization via arteries and veins,and 4 underwent embolization only via arteries.The embolic materials were polyvinyl alcohol granules and coils.The follow-up period was 9—18 months and the curative effect was observed.Results Among the 7 patients,4 cases of acute massive hemorrhage were effectively controlled after interventional operation,3 cases of chronic bleeding disappeared after interventional operation.No recurrence of bleeding occurred during the follow-up period,only 1 patient presented with oral infection and gingival swelling and hyperplasia.The symptoms were effectively controlled after anti-infection and debridement.No severe complications occurred in all patients.Conclusion Interventional therapy for ateriovenous malformation with hemorrhage is effective,safe and feasible,which is worthy of clinical application.