摘要
目的 探讨先天性颈静脉扩张的临床特点、手术方法及预后.方法 回顾性分析2008年1月至2013年8月间收治的18例先天性颈静脉扩张患儿的临床资料.其中,男10例,女8例;年龄4～12岁.颈内静脉扩张18例,全部为单侧,右侧16例,左侧2例.同时合并颈外静脉扩张1例,同侧颈部血管瘤1例.患儿均在哭闹、大声叫喊时发现颈部包块,平静时减小或消失,观察包块时间为6个月～3年,包块均逐渐增大.5例患儿感颈部难受不适,其余病例无明显不适.屏气时包块直径为4～5 cm,平均（4.6±0.4）cm.术前均行Valsalva实验,主要依据B型超声下屏气后患侧颈内静脉径线测值大于平静时自身颈内静脉内径的2倍以上诊断,术中确诊.13例行病理检查发现病变的静脉壁变薄,弹力纤维明显减少,缺乏平滑肌纤维.全组均采用非阻断自身血管反转包裹加强前壁颈静脉成型术治疗.结果 18例先天性颈静脉扩张患儿全部手术顺利,术前B型超声诊断与术中确诊符合率为100％,全部治愈出院.18例术后均获随访,随访3.5～9年,尚未发现复发、血栓形成等病例.结论 非阻断自身血管反转包裹加强前壁颈静脉成型术治疗先天性颈静脉扩张,操作简单,危险性小,术后效果好,值得推广.
Objective To explore the clinical characteristics,operative approaches and outcomes of congenital jugular phlebectasia.Methods Retrospective analyses were conducted for the clinical data of 18 cases of congenital jugular phlebectasia.There were 10 boys and 8 girls with an age range of 4-12 years.The involved side was right （n =16） and left （n =2）.And concurrent conditions included external jugular vein （n =1） and ipsilateral hemangioma （n =1）.Lump became more noticeable on all patients＆#39; neck when crying or shouting and disappeared upon calming down.And it enlarged gradually after 6 months to 3 years.Five cases felt uncomfortable while the remainder did not.The average diameter of lump was （4.6 ± 0.4） （4-5） cm while holding breath.Valsalva maneuver was performed preoperatively for all cases.And it was diagnosed when the ultrasonic diameter of jugular vein at the affected side was over two folds greater than that of the opposite side.All cases were confirmed intraoperatively.In pathological examination,diseased vessels of 13 cases were devoid of smooth muscle.And venous wall became thinner and elastic fibers decreased markedly.All patients were operated by wrapping the diameter of jugular veins to normal vessel for strengthening the front vascular wall without interdicting blooc.Results All operations were successful.Compared with preoperative diagnosis and intraoperative ultrasound diagnosis,the coincidence rate was 100%.All cases were cured and followed up for 3.5-9 years.None of them relapsed or developed thrombus.Conclusions Jugular vein wrapping and narrowing for strengthening front vascular wall is both simple and efficacious for congenital jugular phlebectasia.
作者
苏泽礼
单振潮
迟名伟
周雪鸿
刘冬
王婧
冯启立
梁仁章
Su Zeli Shan Zhenchao Chi Mingwei Zhou Xuehong Liu Dong Wang Jing Feng Qili Liang Renzhang(Department of Pediatric Surgery, General Hospital, Ningxia Medical University, Yinchuan 750004, Chin)
出处
《中华小儿外科杂志》
CSCD
2017年第6期451-454,共4页
Chinese Journal of Pediatric Surgery
关键词
颈静脉扩张
畸形
资料分析
Jugular phlebectasia
Malformation
Data analysis
