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目的 :总结治疗儿童期上、下颌骨动静脉畸形治疗后血管复通的临床经验。方法 :回顾分析4例儿童期颌骨动静脉畸形(arteriovenous malformations,AVMs)患者的临床资料。所有患者均接受过至少26个月以上的颌骨AVM的多学科综合治疗,包括超选择性动脉内栓塞、颌骨骨腔内骨蜡填塞联合拔牙术,并应用计算机体层血管造影术(CTA)及数字减影血管造影术(DSA)证实AVM治疗后存在血管复通。对出现血管复通的患者,再次施以超选择性动脉内栓塞联合颌骨骨腔内骨蜡填塞及拔牙(如有必要)的综合治疗。结果:4例患者随访5~14个月,平均9.5个月,均预后良好,无治疗后搏动感存在或出血。结论:儿童期颌骨AVM综合治疗后,极少病例出现治疗后血管复通,再次应用超选择性动脉内栓塞联合颌骨骨腔内骨蜡填塞以及拔牙等综合治疗效果良好,值得推广应用。
OBJECTIVE: To summarize the clinical experience of treatment of vascular recanalization in the treatment of mandibular arteriovenous malformations in childhood. Methods: The clinical data of 4 patients with childhood arteriovenous malformations (AVMs) were retrospectively analyzed. All patients underwent multidisciplinary treatment of maxillary AVM for at least 26 months, including hypersensitive endarterectomy, maxillary intramedullary bone wax packing and tooth extraction, and computed tomography angiography (CTA) ) And digital subtraction angiography (DSA) confirmed the presence of revascularization after AVM. For patients with recurrent vascular recanalization, once again with super-selective intra-arterial embolization combined with bone filling the mandibular bone and tooth extraction (if necessary) comprehensive treatment. Results: Four patients were followed up for 5 to 14 months with an average of 9.5 months, all with good prognosis. There was no pulsatile flu or bleeding after treatment. CONCLUSIONS: Femoral vascular recanalization is rarely seen in children after minimally invasive AVM. In addition, the combination of superselective arterial embolization and bone marrow wax in the mandibular cavity and extraction of tooth extraction is effective. It is worth popularizing and applying.