口腔颌面_头颈部静脉畸形诊治指南

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1、中国口腔颌面外科杂志2011年11月第9卷第6期·510·ChinaJournalofOralandMaxillofacialSurgeryVol．9No．6November,2011［文章编号］1672-3244(2011)06-0510-08·临床指南·ClinicalGuideline口腔颌面－头颈部静脉畸形诊治指南中华口腔医学会口腔颌面外科专业委员会脉管性疾病学组[提要]静脉畸形是常见的良性病变，约40%发生于头颈部，严重影响患者的容貌和功能，甚至可并发大出血或呼吸道梗阻而危及生命。目前采用的治疗方法有手术、激光、硬化剂注射等。小而浅表的

2、静脉畸形治疗较为简单，效果良好；而累及多个解剖分区的深部、广泛病变治疗困难，是临床上面临的一大挑战。对于复杂病例，单一治疗方法的效果欠佳，需根据患者的病情和医疗机构的技术条件，制定个体化治疗方案，采用综合序列治疗，以期获得最佳疗效。本文参考国内外相关文献和诊治经验，制定口腔颌面－头颈部静脉畸形诊治指南，希望对临床规范治疗起到指导作用。本指南将及时予以更新，以反映和纳入最新研究成果，为广大患者提供最好的治疗方案。[关键词]口腔颌面部；头颈部；静脉畸形；治疗指南[中图分类号]R739.8[文献标志码]ATreatmentguidelineoforo-

3、maxillofacialheadandneckvenousmalformationsDivisionofVascularAnomalies,ChineseSocietyofOralandMaxillofacialSurgery,ChineseStomatologicalAssociation[Summary]Venousmalformationsarethemostcommonsymptomaticlow-flowvascularmalformations,about40%ofthemoccurredintheheadandneckregion

4、s.Theymaybecosmeticallydisfiguring，causepain，ulcerate，bleed，orcompressorinvadeadjacentstructures,impedespeechandswallowing,andobstructupperairway.Currenttreatmentmethodsincludesurgery,lasertherapy,sclerotherapywithvarioussclerosingagents,andetc.Treatmentofsmallandsuperficialv

5、enousmalformationissimpleandtheresultisreliable；however，forthosedeepandextensivelesions，treatmentbecomesdifficultandevenchallenging.Duetotheadvantageanddisadvantageforeachmodality,theselectionoftreatmentmodalitiesshouldbedependentonthepatient’sstatusandtechniqueavailable.Thet

6、reatmentstrategyshouldbeindividualizedandmultidisciplinaryforcomplicatedcases,inordertoachieveeffectiveresults.Basedonthepublishedliteraturesandclinicalexperiences,weestablishatreatmentguidelineforthemanagementoforo-maxillofacialandheadandneckvenousmalformations.Thisprotocolw

7、illberenewedandupdatedtoincludeandreflectthecuttingedgeknowledge,andprovidenewesttreatmentmodalitiesforphysiciansinvolvinginthisspecialty.[Keywords]Oralandmaxillofacialregion；Headandneck;Venousmalformations；TreatmentguidelineChinaJOralMaxillofacSurg,2011,9(6):510-517．静脉畸形是最常见

8、的低流速脉管畸形，由大小统发育缺陷所致。在一些伴静脉畸形的综合征患者不等的扩张静脉构成，病变与身体呈比例生长，终身（如蓝色橡皮泡痣综合征