摘要
目的探讨无水乙醇联合30 g/L聚多卡醇注射液治疗下肢静脉畸形栓塞效果及对血流动力学的影响。方法选取2020年6月—2023年5月在本院接受治疗的60例下肢静脉畸形病人为研究对象,所有病人均在全身麻醉下给予无水乙醇联合30 g/L聚多卡醇注射液治疗。观察病人栓塞治疗效果;比较心率(HR)、血压波动时注射前(T_(0))、最低(T_(1))、最高(T_(2))、恢复后(T_(3))时病人HR、收缩压(SBP)和舒张压(MBP)的差异;比较病人治疗前与治疗后3 d时彩色多普勒超声血流参数的差异;采用酶联免疫吸附试验(ELISA)法检测治疗前及治疗后3 d、1个月、3个月时病人炎症因子水平。结果60例下肢静脉畸形病人共行硬化剂治疗122次,临床治疗总有效率为100%。与T_(0)时比较,T_(1)时HR升高,DBP和SBP降低;与T_(1)时比较,T_(2)、T_(3)时HR降低,DBP和SBP升高;与T_(2)时比较,T_(3)时HR升高,DBP和SBP降低,差异均有统计学意义(F=77.692~1748.358,P<0.001)。与治疗前比较,治疗后3 d时病人的阻力指数(RI)升高,而舒张末期血流速度(EDV)、收缩期峰值血流速度(PSV)降低,治疗后3 d、1个月、3个月时的白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平明显降低,差异均有统计学意义(t=-3.341~15.593,F=1260.135、543.456,P<0.05),IL-10水平比较差异无显著性(P>0.05)。治疗后1、3个月时病人的IL-6、TNF-α水平明显低于治疗3 d时,治疗3个月时病人的IL-6、TNF-α水平明显低于治疗后1个月时,差异均有统计学意义(P<0.05)。结论无水乙醇联合30 g/L聚多卡醇能有效治疗下肢静脉畸形,使术后血流动力学恢复正常,改善彩色多普勒超声血流参数,降低炎症水平。
Objective To investigate the embolization and hemodynamic effects of absolute ethanol combined with 30 g/L polidocanol in lower limb venous malformations.Methods We included 60 patients with lower extremity venous malformations who were treated in our hospital from June 2020 to May 2023.They received injection of absolute ethanol combined with 30 g/L polidocanol under general anesthesia.We observed the effectiveness of embolization in the patients;compared heart rate(HR),systolic blood pressure(SBP),and diastolic blood pressure(DBP)before injection(T_(0)),at the time of the lowest(T_(1)),at the time of the highest(T_(2)),and after recovery(T_(3));compared the blood flow parameters of color Doppler ultrasonography before and at 3 d after treatment;and measured the levels of inflammatory factors by enzyme-linked immunosorbent assay before treatment and at 3 d,1 month,and 3 months after treatment.Results A total of 122 sessions of sclerotherapy were performed in the 60 patients with lower extremity venous malformations,with an overall response rate of 100%.Compared with T_(0),HR was significantly increased and DBP and SBP were significantly decreased at T_(1);compared with T_(1),HR was significantly decreased and DBP and SBP were significantly increased at T_(2)and T_(3);and compared with T_(2),HR was significantly increased and DBP and SBP were significantly decreased at T_(3)(F=77.692-1748.358,P<0.001).Compared with before treatment,the resistance index(RI)was significantly increased,and the end-diastolic blood flow velocity(EDV)and peak systolic blood flow velocity(PSV)were significantly decreased at 3 d after treatment;the levels of interleukin(IL)-6 and tumor necrosis factor-α(TNF-α)were significantly decreased at 3 d,1 month,and 3 months after treatment(t=-3.341 to 15.593,F=1260.135,543.456,P<0.05);and there was no significant difference in the level of IL-10(P>0.05).IL-6 and TNF-α levels were significantly lower at 1 month and 3 months than at 3 d and significantly lower at 3 months than at 1 month after treatment(all P<0.05).Conclusion The combination of absolute ethanol and 30 g/L polidocanol has a significant embolization effect for lower limb venous malformations,with normal hemodynamics,better blood flow parameters,and lower inflammatory levels after the procedure.
作者
潘丽红
孙明飞
孟庆江
巩宗锴
饶德新
PAN Lihong;SUN Mingfei;MENG Qingjiang;GONG Zongkai;RAO Dexin(Department of Cardiovascular Surgery,First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《青岛大学学报(医学版)》
2025年第2期270-274,共5页
Journal of Qingdao University(Medical Sciences)
基金
二〇二二年开封市科技发展计划项目(2203-019)
河南省二〇二一年科技发展计划项目(212102310165)。
关键词
乙醇
聚多卡醇
动静脉畸形
栓塞
血流动力学
ethanol
polidocanol
arteriovenous malformations
embolism
hemodynamics
