纤维蛋白胶复合平阳霉素栓塞硬化治疗口腔颌面部血管畸形专家共识

doi:10.19439/j.sjos.2026.03.001

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (3): 225-232.doi: 10.19439/j.sjos.2026.03.001

纤维蛋白胶复合平阳霉素栓塞硬化治疗口腔颌面部血管畸形专家共识

杨耀武¹, 郑家伟², 范新东³, 刘少华⁴, 秦中平⁵, 孙沫逸¹, 陈伟良⁶, 郭新奎⁷, 魏建华¹, 蔡志刚⁸, 季彤⁹, 李春洁¹⁰, 郭伟², 龚忠诚¹¹, 侯劲松¹², 苏立新³, 王德明³, 王延安², 任国欣², 陈安威⁴, 李克雷⁵, 那思家¹³, 蔡育¹⁴, 刘法昱¹⁵, 麦华明¹⁶, 吴海威¹⁷, 闫志伟¹, 杨霞¹, 候娜¹

1.空军军医大学口腔医院口腔颌面-头颈肿瘤科,口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,陕西西安 710032;
2.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科, 3.介入科,上海 200011;
4.山东大学齐鲁医院口腔颌面外科,山东济南 250012;
5.山东省临沂市肿瘤医院血管瘤脉管畸形专科,山东临沂 276001;
6.中山大学孙逸仙纪念医院口腔颌面外科,广东广州 510120;
7.西安交通大学第二附属医院小儿外科,陕西西安 710004;
8.北京大学口腔医院口腔颌面外科,北京 100081;
9.复旦大学附属中山医院口腔颌面外科,上海 200030;
10.四川大学华西口腔医院头颈肿瘤外科,四川成都 610041;
11.新疆医科大学第一附属医院（附属口腔医院）口腔颌面肿瘤外科,新疆乌鲁木齐 830054;
12.中山大学附属口腔医院口腔颌面外科,广东广州 510055;
13.西安交通大学口腔医院口腔外科门诊,陕西西安 710004;
14.武汉大学口腔医院口腔颌面外科,湖北武汉 430079;
15.中国医科大学附属口腔医院口腔颌面头颈外科,辽宁沈阳 110002;
16.桂林医科大学附属口腔医院口腔颌面外科,广西桂林 541001;
17.山东第一医科大学附属省立医院口腔颌面外科,山东济南 250021

收稿日期:2025-11-20 修回日期:2025-12-12 发布日期:2026-07-02
通讯作者: 杨耀武,E-mail： yangyaowu_1@sina.com
作者简介:杨耀武（1968—）,男,博士,教授、主任医师
基金资助:
国家自然科学基金面上项目（81470757）; 陕西省重点研发计划重点产业创新链（群）项目(2022ZDLSF03-13); 空军军医大学第三附属医院国家口腔疾病临床医学中心临床研究课题（LCB202002）; 空军军医大学临床研究课题（2024LC2443,单病种库专项）

Expert consensus on embolization and sclerotherapy with fibrin glue combined with pingyangmycin for oral and maxillofacial vascular malformations

Yang Yaowu¹, Zheng Jiawei², Fan Xindong³, Liu Shaohua⁴, Qin Zhongping⁵, Sun Moyi¹, Chen Weiliang⁶, Guo Xinkui⁷, Wei Jianhua¹, Cai Zhigang⁸, Ji Tong⁹, Li Chunjie¹⁰, Guo Wei², Gong Zhongcheng¹¹, Hou Jinsong¹², Su Lixin³, Wang Deming³, Wang Yan'an², Ren Guoxin², Chen Anwei⁴, Li Kelei⁵, Na Sijia¹³, Cai Yu¹⁴, Liu Fayu¹⁵, Mai Huaming¹⁶, Wu Haiwei¹⁷, Yan Zhiwei¹, Yang Xia¹, Hou Na¹

1. Department of Oral and Maxillofacial-Head and Neck Oncology, School of Stomatology, The Air Force Military Medical University;State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration; National Clinical Research Center for Oral Diseases; Shaanxi Key Laboratory of Stomatology. Xi'an 710032, Shaanxi Province;
2. Department of Oromaxillofacial Head and Neck Oncology, 3. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
4. Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University. Jinan 250012, Shandong Province;
5. Special Department of Vascular Anomalies, Linyi Tumor Hospital. Linyi 276000, Shandong Province;
6. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Guangzhou 510120, Guangdong Province;
7. Department of Pediatric Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University. Xi'an 710004, Shaanxi Province;
8. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. Beijing 100081;
9. Department of Oral and Maxillofacial Surgery, Zhongshan Hospital, Fudan University. Shanghai 200030;
10. Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University. Chengdu 610041, Sichuan Province;
11. Oncological Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Xinjiang Medical University, School/Hospital of Stomatology Xinjiang Medical University. Urumqi 830054, Xinjiang Uygur Autonomous Region;
12. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-Sen University. Guangzhou 510055, Guangdong Province;
13. Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University. Xi'an 710004, Shaanxi Province;
14. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University. Wuhan 430079, Hubei Province;
15. Department of Oral Maxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University. Shenyang 110002, Liaoning Province;
16. Department of Oral and Maxillofacial surgery, College &hospital of Guilin Medical university. Guilin 541001, Guangxi Province;
17. Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University. Jinan 250021, Shandong Province, China

Received:2025-11-20 Revised:2025-12-12 Published:2026-07-02

摘要/Abstract

摘要： 血管畸形是口腔颌面部常见的脉管异常,可造成患者颜面畸形、颅颌面系统功能障碍及社会心理压力。目前,在大范围、高回流静脉畸形以及高流速动静脉畸形治疗领域仍然面临挑战。纤维蛋白胶复合平阳霉素或博来霉素栓塞硬化技术通过“即时栓塞-药物缓释-协同纤维化”的机制治疗血管畸形,已有的研究数据显示,其在治疗大范围、高回流静脉畸形以及部分动静脉畸形方面呈现出一定优势,具有良好的应用前景。该技术应用已经有20余年历史,但因缺少规范化、指导性应用方案,其推广受到一定限制。本共识介绍了纤维蛋白胶复合平阳霉素栓塞硬化技术的提出背景、相关基础及临床研究,并探讨了其消除血管畸形的可能机制。本共识借鉴和参考该领域最新研究成果和治疗经验,汇总国内多个医疗机构相关专家的讨论意见,从适应证与禁忌证、治疗前准备、治疗操作规范、潜在并发症防治及综合运用等方面,为该技术的临床应用提供指导性建议,以供临床实践参考。

关键词: 纤维蛋白胶, 平阳霉素, 血管畸形, 栓塞, 硬化治疗, 专家共识

Abstract: Venous malformations(VMs) are common vascular anomalies in the oral and maxillofacial region, which can cause facial deformities, craniomaxillofacial dysfunction and psychosocial stress in patients. Currently, the treatment of extensive, high-reflux venous malformations and high-flow arteriovenous malformations(AVMs) remains challenging. Fibrin glue combined with pingyangmycin or bleomycin embolosclerotherapy technology treats vascular malformations via the mechanism of immediate embolization, sustained drug release and synergistic fibrosis. Existing real-world research data have demonstrated its potential advantages in managing extensive, quick drainage venous malformations and certain arteriovenous malformations, indicating promising application prospects. The application of this technique has a history of over two decades; however, its promotion has been constrained due to the lack of standardized and guided application protocols. This consensus document elaborated on the background, basic research, and clinical studies related to fibrin glue combined with pingyangmycin embolosclerotherapy, and discusses its mechanism of action in eliminating vascular malformations. By integrating the latest research findings and clinical experiences in the field, as well as incorporating discussions and opinions from experts across multiple medical institutions in China, this consensus provides guidance on clinical applications including indications and contraindications, pre-treatment preparations, procedural standards, prevention and management of potential complications, and comprehensive implementation, so as to serve as a reference for clinical practice.

Key words: Fibrin glue, Pingyangmycin, Vascular malformations, Embolization, Sclerotherapy, Expert consensus

中图分类号:

R782.2

杨耀武, 郑家伟, 范新东, 刘少华, 秦中平, 孙沫逸, 陈伟良, 郭新奎, 魏建华, 蔡志刚, 季彤, 李春洁, 郭伟, 龚忠诚, 侯劲松, 苏立新, 王德明, 王延安, 任国欣, 陈安威, 李克雷, 那思家, 蔡育, 刘法昱, 麦华明, 吴海威, 闫志伟, 杨霞, 候娜. 纤维蛋白胶复合平阳霉素栓塞硬化治疗口腔颌面部血管畸形专家共识[J]. 上海口腔医学, 2026, 35(3): 225-232.

Yang Yaowu, Zheng Jiawei, Fan Xindong, Liu Shaohua, Qin Zhongping, Sun Moyi, Chen Weiliang, Guo Xinkui, Wei Jianhua, Cai Zhigang, Ji Tong, Li Chunjie, Guo Wei, Gong Zhongcheng, Hou Jinsong, Su Lixin, Wang Deming, Wang Yan'an, Ren Guoxin, Chen Anwei, Li Kelei, Na Sijia, Cai Yu, Liu Fayu, Mai Huaming, Wu Haiwei, Yan Zhiwei, Yang Xia, Hou Na. Expert consensus on embolization and sclerotherapy with fibrin glue combined with pingyangmycin for oral and maxillofacial vascular malformations[J]. Shanghai Journal of Stomatology, 2026, 35(3): 225-232.

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纤维蛋白胶复合平阳霉素栓塞硬化治疗口腔颌面部血管畸形专家共识

Expert consensus on embolization and sclerotherapy with fibrin glue combined with pingyangmycin for oral and maxillofacial vascular malformations

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