目的 观察彩色超声全时监测下经皮低功率动态射频消融治疗静脉畸形的有效性和安全性.方法 回顾性分析2014年12月至2015年12月收治的经皮射频消融治疗的24例复杂静脉畸形患者资料,男14例,女10例,年龄1.5~42.0岁,中位年龄11岁.分为局限深在型病变组11例和广泛性病变组13例.合并凝血功能障碍4例.采用彩色超声全时监测下低功率动态消融技术进行治疗,按4级分级标准对治疗效果进行评价.结果 随访15~28个月,疗效评价Ⅰ级(差)0例,Ⅱ级(中)3例,Ⅲ级(好)9例,Ⅳ级(优)12例.4例凝血功能障碍患者凝血功能得到改善.局限深在型病变组(9/11)和广泛性病变组(3/13)疗效评定为Ⅳ级率的比较,差异有统计学意义(P<0.05).结论 低功率动态射频消融技术治疗复杂静脉畸形,具有安全、有效、外形好的特点,可作为硬化或手术等治疗效果不佳患者的有效替代方案,尤其适用于深在病变;对合并凝血功能障碍的广泛性病变可有效纠正凝血功能紊乱.
Objective To observe the clinical effects and complications of percutaneous radio frequency ablation.Methods Clinical records from 24 patients with complex venous malformations that underwent percutaneous radiofrequency ablation (RFA) from Dec.2014 to Dec.2015 at a singleinstitution were reviewed.There were 14 males and 10 females.The median age was 11 years ranging from 1.5 to 42 years.There were 13 cases with extensive lesions and 11 cases with deep localized lesions.Coagulopathy occurred in 4 patients with extensive lesions.Ablation procedures were performed under real-time color Doppler monitoring by percataneous radiofrequency dynamic ablation with low power,and the therapeutic efficacy was evaluated on a 4-level scale.Results There were 12 grade Ⅳ cases,9 grade Ⅲ cases,3 grade Ⅱ cases and 0 grade Ⅰ case after 15 to 28 months' follow-up.All 4 patients had improvement in coagulopathy.There were 9 cases with grade Ⅳ therapeutic efficacy in patients with deep localized lesions,compared to 3 in patients with extensive lesions,which indicated a significant differences between these two groups (P<0.05).Conclusions Moving radiofrequency ablation with low power is feasible and safe in venous malformations treatment,which can be recommended as the replacement for surgery or sclerotreatment,being especially indicated in those with deep lesions.Obvious improvement in coagulopathy and pathogenetic condition can be achieved after ahlation in those with extensive lesions.