神经肌腱及其周围肌内静脉畸形的手术治疗

摘要

目的 评价神经肌腱及其周围的肌内静脉畸形的手术治疗效果,总结手术操作步骤及个体化手术方式选择.方法 河南省人民医院血管瘤外科2012年1月至2014年12月收治114例神经肌腱及其周围的肌内静脉畸形患者,根据病情制定个体化手术方式.随访1～3年,平均随访1.8年,对手术治疗进行总结,复查影像学检查,评估临床症状及肢体功能.效果评价标准:(1)无效,临床症状和影像学阳性检查无改善或加重.(2)好转,临床症状和影像学阳性检查改善.(3)治愈,临床症状和影像学阳性检查消失.结果 114例获得1～3年随访,平均1.8年,无效3例,好转26例,治愈85例;手术治疗有效率为97％,术后1年治愈率为75％.结论 神经肌腱及其周围肌内静脉畸形治疗比较困难,可选择治疗方法较少,手术治疗是安全有效的治疗方法之一.%Objective This study aims (1) to evaluate the surgical outcome of intramuscular venous malformations,and associated nerve and tendon encapsulated;(2) to summarize the surgical procedure,with the purpose of providing individualized surgical treatment.Methods This is a retrospective study of 114 patients of intramuscular venous malformations with associated nerve and tendon encapsulated.All the patients were admitted in the Henan Provincial People's Hospital from January 2012 to December 2014.The surgeries were produced,according to the patient's condition.The surgical outcome was evaluated after 1-3 years follow up,by the overall evaluation of radiological imaging,symptoms and functions of limbs.The evaluation criteria:(1) Invalid:clinical symptoms or radiological imaging showed no improvement or even worsen;(2) Improvement:clinical symptoms or radiological imaging was significantly improved;(3) Cure:clinical symptoms were gone or the radiological imaging was normal.Results All the 114 patients were followed up for 1-3 years,with the average of 1.8 years.Three cases were evaluated as invalid,26 cases were improved,and 85 cases were cured.The effective rate was 97％,and the cure rate was 75％ on 1 year after surgery.Conclusions It is difficult to treat intramuscular venous malformations as it often involves nerve and tendon.Universal treatment is few.Therefore,an individualized surgical plan is recommendable.