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目的探讨猪尾引流导管在大囊型及混合型淋巴管畸形硬化治疗中的应用及疗效。方法回顾性分析2011年1月至2014年1月确诊并接受猪尾引流导管硬化治疗的26例大囊型及混合型淋巴管畸形患儿临床资料。术前彩色超声、CT或MRI检查结合术中穿刺液检查进一步确诊。全身麻醉后在彩色超声引导下置入猪尾引流导管作引流,每日予平阳霉素溶液作冲洗硬化治疗,拔管前囊腔内保留少量平阳霉素溶液;拔管4周未达到治愈标准者,予平阳霉素局部注射治疗,4周后再评估是否继续注射。结果 26例患儿共置入引流导管26次,冲洗硬化治疗105次。20例患儿经1次置管硬化治疗后达治愈标准,拔管后无需平阳霉素局部注射治疗;2例局部注射1次,2例局部注射2次后达治愈标准;2例局部注射2次后达好转标准。术后随访6~36个月,24例临床症状消除,影像学检查未见瘤体或仅有少量残余硬化病灶,无复发;2例瘤体缩小50%以上,影像学检查仍有少量囊性病灶残余,建议继续随访。本组总治愈率为92.3%,有效率达100%。结论猪尾引流导管应用于硬化治疗大囊型及混合型淋巴管畸形,具有创伤小、治疗周期短、复发率低及安全有效的特点,值得临床推广应用。
Objective To investigate the application and efficacy of pigtail draining catheter in the treatment of macrocystic and mixed lymphatic malformations. Methods The clinical data of 26 patients with macrocystic and mixed lymphatic malformation diagnosed from January 2011 to January 2014 were retrospectively analyzed. Preoperative color ultrasound, CT or MRI combined with intraoperative puncture fluid examination for further diagnosis. After general anesthesia under the guidance of color ultrasound pig tail drainage catheter for drainage, daily Pingyangmycin solution for irrigation sclerosis treatment, extubation before leaving a small amount of pingyangmycin solution; extubation 4 weeks did not meet the cure criteria , To Pingyangmycin local injection therapy, 4 weeks and then assess whether to continue injection. Results 26 cases of children were placed in the drainage catheter 26 times, rinse sclerosis treatment 105 times. 20 cases of children after a catheter sclerosis treatment up to the standard, no need for Pingyangmycin after extubation local injection treatment; 2 cases of local injection 1, 2 cases of local injection of 2 times after the cure standard; 2 cases of local injection 2 Subsequent improvement standards. The patients were followed up for 6 to 36 months. The clinical symptoms were eliminated in 24 cases. There was no tumor or only a small amount of residual sclerosis in the imaging examination. No recurrence was found in 2 cases. The tumor size was reduced by 50% Residual lesions, it is recommended to continue follow-up. The total cure rate of 92.3%, the effective rate of 100%. Conclusion The pigtail drainage catheter is suitable for sclerotherapy of macrocystic and mixed lymphatic malformations. It has the characteristics of small trauma, short treatment period, low recurrence rate and safe and effective treatment. It is worthy of clinical application.