上海口腔医学

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (3): 332-336.doi: 10.19439/j.sjos.2023.03.022

• 临床总结 • 上一篇    

额部动静脉畸形介入栓塞治疗9例临床分析

李晓1, 范新东2, 王德明2, 杨西涛2,*, 苏立新2,*   

  1. 1.上海交通大学医学院附属第九人民医院 口腔第二门诊部,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
    2.上海交通大学医学院附属第九人民医院 介入科,上海 200011
  • 收稿日期:2022-11-02 修回日期:2023-01-20 出版日期:2023-06-25 发布日期:2023-06-28
  • 通讯作者: 杨西涛,E-mail: xitao123456@126.com;苏立新,E-mail: sulixin1975@126.com。*共同通信作者
  • 作者简介:李晓（1991-）,女,博士,E-mail: lixiao1991@yeah.net

Clinical analysis of interventional embolization for 9 cases with frontal arteriovenous malformation

LI Xiao1, FAN Xin-dong2, WANG De-ming2, YANG Xi-tao2, SU Li-xin2   

  1. 1. The 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
    2. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2022-11-02 Revised:2023-01-20 Online:2023-06-25 Published:2023-06-28

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摘要： 目的：探讨通过介入栓塞方式治疗额部动静脉畸形的有效性和安全性。方法：回顾就诊于上海交通大学医学院附属第九人民医院的额部动静脉畸形患者9例,在DSA引导下予以介入栓塞治疗,通过DSA观察病变范围、预测硬化剂注射剂量以使药物注射入病变腔内。观察分析所有患者的疗效、不良反应和并发症。结果：9例患者中,男7例（77.8%）,女2例（22.2%）,年龄1.5~20岁,局部膨隆或肿块是最主要的报告症状（66.7%）。涉及病例的供血动脉包括颞浅动脉和眼动脉,所有额部动静脉畸形病灶均涉及颞浅动脉供血,其中5例额部动静脉畸形由颞浅动脉和眼动脉供血（55.6%）。所有患者在全麻下接受介入栓塞治疗,共治疗19次（每例患者接受1~6次,平均2.1次/例）,无水乙醇的单次应用平均剂量为9.0 mL。5次应用弹簧圈辅助无水乙醇栓塞治疗,共使用80枚弹簧圈,平均4.2枚/次（80枚/19次）。另有3次使用博来霉素、2次使用平阳霉素、1次使用3%聚多卡醇辅助栓塞治疗。9例患者中,4例治愈,3例基本治愈,2例好转,有效率为100%。所有患者均未报告局部并发症或系统性并发症。结论：在额部动静脉畸形的治疗中,根据临床及影像学表现正确诊断,根据DSA造影结果采用无水乙醇介入栓塞,可以减少创伤、改善症状、控制病灶,获得相对满意的治疗效果。

关键词: 额部, 动静脉畸形, 介入栓塞治疗, 无水乙醇

Abstract: PURPOSE: To investigate the efficacy and safety of interventional embolization in the treatment of frontal arteriovenous malformation (AVM). METHODS: A retrospective study was used to analyze 9 patients with frontal AVM who were treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The patients were treated with interventional embolization under the guidance of DSA. The scope of lesions was observed through DSA, and the injection dose of sclerosing agent was predicted so that the drug could be injected into the lesion cavity. The efficacy, adverse reactions and complications of all patients were observed and analyzed. RESULTS: Among the 9 patients, there were 7 males(77.8%) and 2 females(22.2%), aged from 1.5-20 years old. Local swelling or mass was the main reported symptom(66.7%). The blood supply arteries of the cases involved in this study included superficial temporal artery and ophthalmic artery. All patients received interventional embolization treatment under general anesthesia, a total of 19 times (each patient received 1-6 times, average 2.1 times/person), and the average single dose of absolute ethanol was 9.0 mL. A total of 80 coils (4.2 coils/time on average) were used for 5 times (80 coils/19 times) with absolute ethanol embolization. In addition, bleomycin was used 3 times, pingyangmycin was used 2 times, and 3% polydocanol was used 1 time to assist embolization. Among the 9 cases included in this study, 4 cases were cured, 3 cases were basically cured, 2 cases were improved, and the effective rate of treatment was 100%. No local or systemic complications were reported in all patients. CONCLUSIONS: In the treatment of frontal arteriovenous malformation, correct diagnosis according to clinical and imaging manifestations, and interventional embolization with anhydrous ethanol according to DSA angiography results can reduce trauma, improve symptoms, control lesions, and obtain relatively satisfactory treatment results. This scheme is safe and effective.

Key words: Frontal region, Arteriovenous malformation, Interventional embolization, Absolute ethanol

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