摘要
目的探讨超声引导下聚桂醇治疗小儿淋巴管瘤的方法及临床疗效。方法大连市儿童医院自2015年6月至2016年1月收治24例小儿淋巴管瘤,其中男童14例,女童10例;年龄1个月至9岁,平均年龄24. 2个月;病变位于颈部11例,腋下9例,臀部1例,前胸壁2例,膝部1例;单囊3例,多囊21例;肿物大小2. 5 cm×1. 8 cm至12 cm×6. 3 cm,平均大小3. 4 cm×5. 6 cm。硬化剂配制方法采用Tessari法,超声定位注射前尽量抽除囊液尽快注射,注入泡沫硬化剂至囊腔内完全充满药物,单次总剂量<40 mL。2个月后超声复查观察瘤体变化,根据瘤体大小及治疗情况可多次注射。结果所有患儿获得随访,随访时间3个月至1年。24例均有效,总有效率为100%,其中治愈18例(75%),显效4例(17%),有效2例(8%)。1例出现短暂血管迷走神经性晕厥。结论超声引导下采用1%聚桂醇注射液(液气比1∶2)治疗小儿淋巴管瘤具有安全有效、微创、并发症少等优点,值得临床推广。
Objective To evaluate the clinical curative effect of lauromacrogol guided by ultrasound in the treatment of pediatric lymphangioma. Methods A total of 24 cases with clinically confirmed lymphangioma (LM) were recruited.There were 14 boys and 10 girls with a median age of 24.2(1-108) months.The size of lesion varied from 2.5 cm×1.8 cm to 12 cm×6.3 cm with an average of 3.4 cm×5.6 cm.The sites included neck (n=11),under axillary fossa (n=9),hip (n=1),anterior chest wall (n=2) and knee (n=1).Cysts were single (n=3) and multilocular (n=9).Lauromacrogol foam sclerosant was prepared according to the Tessari formula.Ultrasound was employed for locating and observing cyst cavity.Lymph fluid should be aspirated as quickly as possible prior to injection.Injection was made until sclerosing foam was full within the cavity.The total dose of sclerosing was less than 40 ml.Ultrasound was used for reconfirming the location and size of cyst cavity after 2 months.Based upon the ultrasonic size of LM,injection was repeated whenever necessary. Results Over a follow-up period of 3-12 months,the total responsive rate was 100%.The outcomes were curing (n=18,75%),efficacious (n=4,17%) and effective (n=2,8%).One case experienced transient vasovagal syncope. Conclusion With a liquid-to-air ratio of 1:2,1% lauromacrogol is both safe,mini-invasive and effective for pediatric lymphangioma under ultrasonic guidance.With fewer complications,it is worthy of wider popularization.
作者
周立军
李功俊
沈刚
Zhou Lijun;Li Gongjun;Shen Gang(Ward II,Department of Surgery,Municipal Children's Hospital,Dalian 116012,China)
出处
《临床小儿外科杂志》
CAS
2018年第12期950-953,共4页
Journal of Clinical Pediatric Surgery
关键词
超声引导
聚桂醇
淋巴管瘤
儿童
Ultrasound Guided
Lauromacrogol
Lymphangioma
Child
