博来霉素多点注射联合介入栓塞治疗眼眶血管畸形的临床研究

Clinical study on multi-point bleomycin injection combined with interventional embolization for orbital vascular malformations

摘要:

目的 评估博来霉素多点注射联合介入栓塞治疗在治疗眼眶血管畸形中的临床疗效及安全性。方法 选取2020年1月—2023年12月在中国人民解放军陆军第七十三集团军医院接受治疗的115例眼眶血管畸形患者为研究对象。随机分为两组，对照组（57例）接受经导管动脉硬化栓塞治疗，治疗组（58例）接受博来霉素多点注射联合经导管动脉硬化栓塞治疗。采用数字减影血管造影指导介入治疗，并通过临床症状改善情况、瘤体面积变化、瘤体厚度变化、影像学评估及不良反应发生率等评价治疗效果。结果 治疗组的总有效率达到100%，高于对照组的85.96%（P <0.05）。治疗组治疗前后瘤体面积与瘤体厚度的差值均大于对照组（P <0.05）。影像学评估显示，治疗后眼眶血管畸形显著缩小，周围肿胀组织逐步恢复至正常状态。治疗组和对照组的不良反应发生率分别为3.44%和8.77%，差异无统计学意义（P >0.05）。两组均无严重并发症报告。结论 博来霉素多点注射联合经导管动脉硬化栓塞治疗在改善眼眶血管畸形临床症状和减小瘤体尺寸方面表现出显著优势，并且不良反应发生率较低，是一种有效且安全的治疗策略。

Abstract:

Objective To evaluate the clinical efficacy and safety of multipoint bleomycin injection combined with interventional embolization for orbital vascular malformations.Method This study included 115 patients with orbital vascular malformations treated at our hospital (January 2020 - December 2023). Patients were randomly divided: control group (n = 57) received transcatheter arterial embolization (TAE); treatment group (n = 58) received multipoint bleomycin injection combined with TAE. Digital subtraction angiography (DSA) guided the interventions. Treatment effectiveness was evaluated by clinical symptom improvement, changes in lesion area and thickness, imaging findings, and adverse reaction incidence.Results The total effective rate was 100% in the treatment group, significantly higher than the control group's 85.96% (P < 0.05). The reductions in lesion area and thickness were significantly greater in the treatment group than in the control group (P < 0.05); the control group showed no significant changes. Imaging evaluation revealed a significant reduction in vascular malformations after treatment, with surrounding swollen tissues gradually returning to normal. The incidence of adverse reactions was 3.44% (treatment group) and 8.77% (control group), with no statistically significant difference (P > 0.05). No severe complications were reported in either group.Conclusion The combination of multipoint bleomycin injection and transcatheter arterial embolization significantly improves clinical symptoms, reduces lesion size in orbital vascular malformations, and has a low adverse reaction rate, demonstrating efficacy and safety.