铜针留置治疗静脉畸形对体内溶血的影响(1)
[摘要]目的：探讨铜针留置治疗静脉畸形是否会导致体内溶血。方法：1999年1月～2006年1月采用铜针留置治疗静脉畸形46例，男24例，女22例；年龄10～50岁，中位年龄20岁。病变范围6cm×4cm～40cm×25cm。留置铜针10～45枚/例，平均28枚，留置时间7天。术后密切观察患者全身和局部变化以及有无急性溶血临床表现，检测其中8例患者留置铜针前及留置1、4、7天后血清胆红素、外周血红细胞及网织红细胞数、尿血红蛋白及含铁血黄素。结果：本组46例留置铜针后9例出现腹痛、恶心、呕吐等症状,无急性溶血临床表现，8例留置铜针1、4、7天后，血清总胆红素及间接胆红素升高无显著性(P>0.05)，尿血红蛋白及含铁血黄素阴性，外周血红细胞比术前显著减少(P<0.05)但仍在正常范围，网织红细胞在留置铜针7天后显著升高并超出正常范围(P<0.05)。结论：铜针留置治疗血管瘤可引起体内轻度溶血。
[关键词]静脉畸形；铜针；溶血
[中图分类号]R6223[文献标识码]A[文章编号]1008-6455(2008)10-1488-03
, 百拇医药
Copper needle retained in malformed venouse effect on hemolysis in vivo
FU Shi-zhang,YIN Guo-qian,WANG Bin,HUANG He-ping,HUANG Lin-ling
(Department of Cosmetic and Plastic,Jiangxi Women and Children Health Care Hospital,Nanchang 330006,Jiangxi,China)
Abstract： ObjectiveTo explore whether copper needles retained in malformed venouse will induce hemolysis in vivo.Methods46 cases with venouse malformation treated by 10 to 45 copper needles retained in malformed venouse for seven days from January 1999 to January 2006 were reviewed retrospectively, including 24 males and 22 females whose age ranged from 10～50 years and mean age was 20 years. These malformed venouses in size ranged from 6 cm×4 cm to 40 cm×25 cm. During the copper needle retainment,all the cases were observed for the whole and local symptom,as well as manifestation of acute hemolysis in vivo. The content of bilirubin in circular serum, amount of RBC and reticulocyte in circular blood,hemosiderin and hematoglobin in urine of 8 cases were detected before treatment and after copper needles retained for 1, 4, 7 days.Results46 cases had no clinical manifestation of acute hemolysis in vivo after copper needles retainment, except that 9 cases of them had the sensations of abdominal pain,nausea ,vomiting, and so on. After copper needles retained for 1, 4, 7 days, the content of total bilirubin and indirect bilirubin in circular serum increased with no statistical significance compared with that before treatment(P>0.05);hemosiderinuria and hematoglobinuria were negative. However, the amount of RBC in circular blood decreased remarkably with statistical significance despite within normal scale(P<0.05),and the amount of reticulocyte in circular blood increased so evidently as to overstep normal scale after 7 days of copper needles retainment(P<0.05).ConclusionCopper needle retained in malformed venouse will induce slight hemolysis in vivo.
, 百拇医药
Key words: venouse malformation;copper needle;hemolysis
铜针治疗血管畸形在国内始于20世纪90年代，因其疗效肯定、手术痛苦少、方法简便易行、出血少，对形态和功能影响小[1-2]而成为近年国内学者治疗体表弥漫性静脉畸形的常用方法，然而，治疗过程中是否会导致体内铜过量而引起溶血倍受学者们关注。1999年1月～2006年1月，我们采用铜针留置治疗静脉畸形50例，并对治疗过程中患者是否出现体内溶血进行监测，现报道如下。
1临床资料
1.1一般资料：本组46例静脉畸形中男24例，女22例，年龄10～50岁，中位年龄20岁。病变部位：上肢12例，下肢31例，躯干2例，臀部1例。病变范围6cm×4cm～40cm×25cm。
1.2治疗方法
1.2.1 铜针准备： 选用直径 1～2mm工业铜丝, 制成长5～10cm、一端打磨成尖、另一端弯成圆形的铜针，用砂纸擦去外包漆及氧化层后环氧乙烷灭菌备用(图1)。
1.2.2 铜针留置：术前标记出病变集中范围为铜针留置部位，臂丛(上肢)、硬膜外(下肢)或全身麻醉(儿童)下，根据术前造影显示将备用铜针由病变周边向中心刺入畸形静脉内，铜针穿过皮下后有明显阻力并有沙沙作响感表示在病灶内，针距2～3cm，置入铜针后局部棉垫加厚包扎。部分患者在留置铜针时予4号或7号丝线每隔3～5cm贯穿病灶深面间断、交错缝扎18～25针，针距2～3cm。本组治疗46例，留置铜针 16～45枚，平均28枚，其中5例治疗两次(图2)。, http://www.100md.com(付时章 殷国前 王 斌 黄和平 黄琳玲)
[关键词]静脉畸形；铜针；溶血
[中图分类号]R6223[文献标识码]A[文章编号]1008-6455(2008)10-1488-03
, 百拇医药
Copper needle retained in malformed venouse effect on hemolysis in vivo
FU Shi-zhang,YIN Guo-qian,WANG Bin,HUANG He-ping,HUANG Lin-ling
(Department of Cosmetic and Plastic,Jiangxi Women and Children Health Care Hospital,Nanchang 330006,Jiangxi,China)
Abstract： ObjectiveTo explore whether copper needles retained in malformed venouse will induce hemolysis in vivo.Methods46 cases with venouse malformation treated by 10 to 45 copper needles retained in malformed venouse for seven days from January 1999 to January 2006 were reviewed retrospectively, including 24 males and 22 females whose age ranged from 10～50 years and mean age was 20 years. These malformed venouses in size ranged from 6 cm×4 cm to 40 cm×25 cm. During the copper needle retainment,all the cases were observed for the whole and local symptom,as well as manifestation of acute hemolysis in vivo. The content of bilirubin in circular serum, amount of RBC and reticulocyte in circular blood,hemosiderin and hematoglobin in urine of 8 cases were detected before treatment and after copper needles retained for 1, 4, 7 days.Results46 cases had no clinical manifestation of acute hemolysis in vivo after copper needles retainment, except that 9 cases of them had the sensations of abdominal pain,nausea ,vomiting, and so on. After copper needles retained for 1, 4, 7 days, the content of total bilirubin and indirect bilirubin in circular serum increased with no statistical significance compared with that before treatment(P>0.05);hemosiderinuria and hematoglobinuria were negative. However, the amount of RBC in circular blood decreased remarkably with statistical significance despite within normal scale(P<0.05),and the amount of reticulocyte in circular blood increased so evidently as to overstep normal scale after 7 days of copper needles retainment(P<0.05).ConclusionCopper needle retained in malformed venouse will induce slight hemolysis in vivo.
, 百拇医药
Key words: venouse malformation;copper needle;hemolysis
铜针治疗血管畸形在国内始于20世纪90年代，因其疗效肯定、手术痛苦少、方法简便易行、出血少，对形态和功能影响小[1-2]而成为近年国内学者治疗体表弥漫性静脉畸形的常用方法，然而，治疗过程中是否会导致体内铜过量而引起溶血倍受学者们关注。1999年1月～2006年1月，我们采用铜针留置治疗静脉畸形50例，并对治疗过程中患者是否出现体内溶血进行监测，现报道如下。
1临床资料
1.1一般资料：本组46例静脉畸形中男24例，女22例，年龄10～50岁，中位年龄20岁。病变部位：上肢12例，下肢31例，躯干2例，臀部1例。病变范围6cm×4cm～40cm×25cm。
1.2治疗方法
1.2.1 铜针准备： 选用直径 1～2mm工业铜丝, 制成长5～10cm、一端打磨成尖、另一端弯成圆形的铜针，用砂纸擦去外包漆及氧化层后环氧乙烷灭菌备用(图1)。
1.2.2 铜针留置：术前标记出病变集中范围为铜针留置部位，臂丛(上肢)、硬膜外(下肢)或全身麻醉(儿童)下，根据术前造影显示将备用铜针由病变周边向中心刺入畸形静脉内，铜针穿过皮下后有明显阻力并有沙沙作响感表示在病灶内，针距2～3cm，置入铜针后局部棉垫加厚包扎。部分患者在留置铜针时予4号或7号丝线每隔3～5cm贯穿病灶深面间断、交错缝扎18～25针，针距2～3cm。本组治疗46例，留置铜针 16～45枚，平均28枚，其中5例治疗两次(图2)。, http://www.100md.com(付时章 殷国前 王 斌 黄和平 黄琳玲)