【肌内静脉畸形致四肢疼痛及手术治疗分析】。

中华整形外科杂志 Pub Date : 2017-01-01
Xiaonan Guo, Changxian Dong, Dakan Liu, Yubin Gong, Junbo Qiao
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引用次数: 0

摘要

目的:分析肌内静脉畸形引起的疼痛,避免误诊。方法:回顾性分析2012年1月至2014年12月在我科手术治疗的173例以局部疼痛为主诉,诊断为肌内静脉畸形的患者。结合影像学资料、术中表现、病理报告及术前、术后视觉模拟评分(VAS)比较,总结局部疼痛的发生机制。手术干预包括单纯切除或切除+粘连松解或切除+粘连松解+神经减压。结果:局部疼痛的原因可分为4类:①病变位于肌腱止点;②病变累及局部神经,引起神经膜外膜增厚、紧张、直径增大;③病变浸润至骨膜;173例患者均接受手术治疗,局部疼痛得到不同程度缓解。63例患者VAS下降5分及以上,95例患者VAS下降3-4分,其余15例患者VAS下降1-2分。结论:肌内静脉畸形是引起局部疼痛的重要原因,不容忽视。手术治疗是切除病变、减轻局部疼痛的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Analysis of the pain in extremities caused by intramuscular venous malformation and surgical treatments].

Objective: To analyze the pain caused by intramuscular venous malformation, so as to avoid misdiagnosis.

Methods: We retrospectively analyzed 173 patients who received surgical treatments in our department between Jan.2012 to Dec.2014,with the main complaint of local pain and were diagnosed as intramuscular venous malformation. The mechanisms of the local pain, based on the image data, intra-operative findings, pathology reports and the comparison of the Visual Analogue Scale(VAS)data before and after operation were summarized. The surgical interventions included simple excision or excision + adhesiolysis or excision + adhesiolysis + nerve decompression.

Results: The reasons of local pain can be divided into 4 categories:①lesion located in the tendon insertions;②lesion involving the local nerve, inducing the thickening and tensing of its epineurium and the increasing of its diameter;③lesion infiltrated to the periosteum;④phlebolith in it. All the 173 patients received surgical treatments and got varying degrees of relieving from local pain.63 patients got a decrease of the VAS by 5 or more, and 95 cases' VAS number decreased by 3-4,the rest 15 patients' VAS cut down by 1-2.

Conclusions: Intramuscular venous malformation is an important reason for local pain and should not be neglected. Surgical treatment can be an effective method to remove the lesion and relieve local pain.

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