舌静脉畸形的DSA分型及治疗—132例临床分析

doi:10.19439/j.sjos.2021.02.007

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (2): 145-150.doi: 10.19439/j.sjos.2021.02.007

舌静脉畸形的DSA分型及治疗—132例临床分析

李嘉朋¹, 冼淡¹, 张国润¹, 贺先明¹, 陈巨峰¹, 李金¹, 张国义²

1.广东省佛山市第一人民医院口腔医学中心,
2.鼻咽放疗二科,广东佛山 528000

收稿日期:2020-06-28 修回日期:2020-08-20 出版日期:2021-04-25 发布日期:2021-05-11
通讯作者: 陈巨峰,E-mail:18038862068@189.cn
作者简介:李嘉朋（1975-）,男,硕士,副主任医师,E-mail:13380261726@189.cn
基金资助:
广东省科技计划项目（2017A020215128）

DSA types and treatment strategy of venous malformations of the tongue： an analysis of 132 consecutive patients

LI Jia-peng¹, XIAN Dan¹, ZHANG Guo-run¹, HE Xian-ming¹, CHEN Ju-feng¹, LI Jin¹, ZHANG Guo-yi²

1. Center of Stomatology,
2. Nasopharyngeal Radiotherapy Department 2, First People's Hospital of Foshan. Foshan 528000, Guangdong Province, China

Received:2020-06-28 Revised:2020-08-20 Online:2021-04-25 Published:2021-05-11

摘要/Abstract

摘要： 目的:探讨舌静脉畸形(venous malformations,VM)的数字减影血管造影（digital substraction angiography, DSA）分型及治疗策略。方法:总结2016年2月—2019年2月收治的132例舌VM患者的DSA表现,根据影像学特征将其分为4型,Ⅰ型为无回流型、Ⅱ型为低回流型、Ⅲ型为高回流型、Ⅳ型为广泛型,依据分型选择不同的治疗方案。无回流型单纯采用平阳霉素进行硬化治疗,低回流型单纯采用聚桂醇泡沫硬化剂进行硬化治疗,高回流型采用无水乙醇结合聚桂醇泡沫硬化剂进行硬化治疗,广泛型先按高回流型进行硬化治疗后再结合整形手术切除。统计各组病例的治疗效果及不良反应。结果:本组132例病例获得12~41个月随访,平均15.8个月,所有患者术后舌VM明显缩小甚至消失。Ⅰ型8例,有效率100%;Ⅱ型17例,有效率100 %;Ⅲ型98 例,有效率90.8 %;Ⅳ型 9例,有效率77.8%。不良反应主要为组织溃烂、坏死,Ⅰ型0例;Ⅱ型1例,发生率5.88%; Ⅲ型16例,发生率16.33%;Ⅳ型7例,发生率77.78%。结论:基于DSA的舌VM分型对临床治疗具有重要指导意义。舌VM中大部分为Ⅲ型病例,Ⅰ型比例最小。经黏膜注射无水乙醇是治疗高回流型和广泛型舌VM的有效方法。

关键词: 舌静脉畸形, 数字减影血管造影, 分型, 治疗

Abstract: PURPOSE: To explore the DSA classification and treatment strategy of tongue venous malformation. METHODS: From February 2016 to February 2019, the DSA manifestations of 132 cases with venous malformations of the tongue were summarized. They were classified into 4 types according to imaging characteristics: typeⅠ(non-drainage type), typeⅡ(lower- drainage type), type Ⅲ (higher-drainage type), type Ⅳ(extensive type). Different therapeutic schemes were selected according to the types. The non- drainage type was treated with pingyangmycin alone, the lower-drainage type was treated with lauromacrogol foam alone, the higher- drainage type was treated with absolute alcohol combined with lauromacrogol foam, the extensive type was treated as higher-drainage type first and then combined with plastic resection. Among the cases, therapeutic effects and adverse reactions of each group were recorded and compared. RESULTS: One hundred and thirty-two cases in this study were followed up for 12 to 41 months with an average of 15.8 months. After sclerosing therapy, the venous malformations of the tongue of all patients significantly reduced or even disappeared. Type Ⅰincluded 8 cases with an efficiency of 100%, type Ⅱ included 17 cases with an efficiency of 100%, type Ⅲ included 98 cases with an efficiency of 90.8%, typeⅣincluded 9 cases, with an efficiency of 77.8%.The main adverse reactions were tissue necrosis: 0 in typeⅠ, 1(5.88%) in typeⅡ, 16(16.33%) in type Ⅲ, and 7(77.78%) in type Ⅳ. CONCLUSIONS: The classification of venous malformations of the tongue based on DSA is significant and valuable in guiding clinical treatment. The majority of tongue venous malformations are type Ⅲ, and the smallest propotion is type Ⅰ. Transmucosal sclerotherapy with absolute ethanol is of significance for the treatment of venous malformations of the tongue classified in type Ⅲ and type Ⅳ.

Key words: Venous malformations of the tongue, Digital substraction angiography, Type, Treatment

中图分类号:

R782.2

李嘉朋, 冼淡, 张国润, 贺先明, 陈巨峰, 李金, 张国义. 舌静脉畸形的DSA分型及治疗—132例临床分析[J]. 上海口腔医学, 2021, 30(2): 145-150.

LI Jia-peng, XIAN Dan, ZHANG Guo-run, HE Xian-ming, CHEN Ju-feng, LI Jin, ZHANG Guo-yi. DSA types and treatment strategy of venous malformations of the tongue： an analysis of 132 consecutive patients[J]. Shanghai Journal of Stomatology, 2021, 30(2): 145-150.

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舌静脉畸形的DSA分型及治疗—132例临床分析

DSA types and treatment strategy of venous malformations of the tongue： an analysis of 132 consecutive patients

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