摘要
目的:观察动脉硬化栓塞术治疗血管瘤合并卡梅现象的疗效,为此类疾病的诊断、治疗提供经验和参考。方法:选取2015年8月—2017年3月在我院治疗的13例血管瘤合并卡梅现象患儿,选择博来霉素+超液化碘油+地塞米松+对比剂形成的乳剂和微球或博来霉素混合微球为栓塞剂,对其进行经动脉硬化栓塞治疗,观察并比较治疗前后的临床效果和检查指标。结果:13例进行动脉硬化栓塞治疗的患儿11例达到治愈,2例达到好转疗效。术前到术后,血小板计数从(34.62±29.97)×10~9/L升高到(212.08±70.10)×10~9/L,纤维蛋白原从(1.06±0.45)g/L提高到(2.10±0.66)g/L,瘤体大小从(74.04±57.51)cm^3减小到(46.94±42.52)cm^3,差异均有统计学意义(t值分别为5.074、8.474、4.985,均P<0.01)。2例患儿达到外科手术标准完成瘤体切除。结论:动脉硬化栓塞术对有明确肿瘤供血动脉的血管瘤及合并有凝血功能异常的患者有显著疗效,且安全、可重复性高,值得推广。建议术前行增强CT仔细评估,并用超声引导轻柔穿刺,选择恰当栓塞材料和局部注射硬化剂补充等,提高手术成功概率。
Objective： To observe and investigate the clinical effect of artery sderoembolization intreatment of hemangioma combined with Kasabach-Merritt phenomenon （KMP）, and to provide experience and reference for the diagnosis and treatment of such disease. Methods： Thirteen patients with hemangioma in children with KMP in Beijing Children’s Hospital from August 2015 to March 2017 were seleted and treated with arterial embolization using emulsion and microspheres （consisting of bleomycin＋lipiodol＋dexamethasone＋ contrast agent） or bleomycin mixed microspheres as emboliaztion agents. The clinical effect and examination indexes were observed and compared before and after treatment. Results ： All the 13 patients treated with arterial embolization were cured （ 11 cases ） or improved （ 2 cases ） . The average of platelet count , fibrinogen and tumor size before and after operation were respectively changed from （34.62±29.97）x109/L to （212.08±70.10）x109/L, （1.06±0.45） g/Lto（2.10±0.66） g/Land（74.04 ±57.51） cm3to （46.94 ± 42.52） cm3, and the differences were significant （t values were 5.074, 8.474 and 4.985 , P 〈0.01）. Two cases reached the standard of surgery and completed the tumor resection. Conclusion： Arterial embolization therapy is a significant, safe and reproducible therapeutic method on hemangioma and coagulation dysfunction. Based on experiences from operations, it is recommended that preoperative enhanced CT which is carefully evaluated, soft puncture guided by ultrasound, appropriate embolic material and local injection, sclerotherapy, etc. should be used to increase the achievement ratio.
出处
《中华介入放射学电子杂志》
2017年第4期205-211,共7页
Chinese Journal of Interventional Radiology：electronic edition
关键词
血管瘤
卡梅现象
动脉硬化栓塞术
Hemangioma
Kasabach-Merritt phenomenon
Arteriosclerosis embolization
