血管瘤和脉管畸形治疗后局部组织凹陷353例临床分析

doi:10.3969/j.issn.1673-0364.2020.03.004

摘要/Abstract

摘要：

目的研究血管瘤和脉管畸形治疗后局部组织凹陷发生的相关因素。

方法回顾分析353例血管瘤和脉管畸形患者资料,对可能与局部组织凹陷发生相关的因素进行统计分析。

结果 353例患者中,存在瘤体局部组织凹陷者17例,总体组织凹陷发生率为4.82%。单因素分析结果显示,同位素治疗、病灶破溃坏死和单纯注射治疗是影响局部组织凹陷的因素(P<0.05)。患者的性别、年龄、病变的类型、冷冻治疗等因素则与局部组织凹陷的发生无明显关系(P>0.05)。Logistic回归分析结果显示,同位素治疗和皮肤破溃均为组织凹陷的独立危险因素,单纯注射治疗是组织凹陷的保护因素。

结论局部注射封闭治疗用于血管瘤和脉管畸形疗效满意,组织凹陷发生率低,推荐作为血管瘤和脉管畸形的主要治疗手段,但应严格遵守注射原则;同位素治疗及病灶破溃坏死是组织凹陷的两个独立危险因素。

关键词: 注射封闭治疗, 血管瘤, 脉管畸形, 破溃, 同位素治疗, 组织凹陷

Abstract:

Objective To investigate the relative factors of local tissue atrophy after treatment of hemangioma (HA) and vascular malformation (VM).

Methods

A retrospective analysis was performed on 353 HA or VM patients from January 2010 to December 2012, and statistical analysis was performed on the factors that may be related to the occurrence of local tissue atrophy.

Results Among the 353 cases, 17 cases suffered tissue atrophy. The overall incidence of tissue atrophy was 4.82%. Single factor analysis of variance showed that isotope therapy, ulceration and sclerotherapy only were the factors affecting local tissue atrophy (P<0.05). Gender, age, type, cryotherapy had no obvious relation with the occurrence of tissue atrophy (P>0.05). Followed multivariate logistic regression analysis showed that isotope therapy and ulceration were independent risk factors for tissue atrophy, and sclerotherapy only was a protected factor.

Conclusion Sclerotherapy is recommended as the main treatment mean of HA and VM, because of its satisfactory effects on the treatment and low incidence of tissue depression. Nonetheless, the principle of injection should be strictly observed. Isotopic therapy and ulceration are two independent risk factors for tissue atrophy.

Key words: Sclerotherapy, Hemangiomas, Vascular malformations, Ulceration, Isotope therapy, Tissue atrophy

中图分类号:

R732.2

孟真, 吕仁荣, 林莉, 霍然. 血管瘤和脉管畸形治疗后局部组织凹陷353例临床分析[J]. 组织工程与重建外科杂志, 2020, 16(3): 189-192.

Zhen MENG, Renrong LV, Li LIN, Ran HUO. Clinical Analysis for Post-Treatment Tissue Atrophy of Hemangiomas and Vascular Malformations: 353 cases[J]. Journal of Tissue Engineering and Reconstructive Surgery, 2020, 16(3): 189-192.

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		凹陷(例) cases with atrophy (n)	未凹陷(例) cases without atrophy (n)	凹陷率% atrophy rate (%)
性别	男 M	5	133	3.62
gender	女 F	12	203	5.58
年龄	≤1Y	11	202	5.16
age	>1Y	6	134	4.29
类型	血管瘤 HA	11	210	4.98
type	脉管畸形VM	6	126	4.55
同位素治疗	Yes	6	15	28.57
isotope therapy	No	11	321	3.31
冷冻治疗	Yes	2	15	11.76
cryotherapy	No	15	321	4.46
破溃	Yes	5	16	23.81
ulceration	No	12	320	3.61
单纯注射治疗	Yes	5	231	2.12
sclerotherapy only	No	12	105	10.26

	β	S.E,	Wals	df	Sig.(P)	Exp (β) (OR)	EXP(β)95%C.I
	β	S.E,	Wals	df	Sig.(P)	Exp (β) (OR)	lower limit	upper limit
同位素治疗(isotope therapy)	2.474	0.659	14.075	1	0.000	11.868	3.259	43.216
破溃(ulceration)	1.770	0.680	6.765	1	0.009	5.870	1.547	22.275
单纯注射治疗(sclerotherapy only)	-1.810	0.598	9.143	1	0.002	0.164	0.051	0.529
常量(constant)	-2.737	0.377	52.599	1	0.000	0.065