Zhang Xiaping,Li Jiehua.Clinical outcomes of sclerotherapy under a day-care model for pediatric venous malformations[J].Journal of Clinical Pediatric Surgery,2025,(12):1169-1174.[doi:10.3760/cma.j.cn101785-202508013-014]
小儿静脉畸形硬化治疗日间管理模式效果与安全性初探
- Title:
- Clinical outcomes of sclerotherapy under a day-care model for pediatric venous malformations
- Keywords:
- Pediatric Venous Malformation; Polidocanol; Day Treatment; Sclerotherapy; Preoperative Anxiety; Parental Satisfaction
- 摘要:
- 目的 初步探讨小儿静脉畸形(venous malformation,VM)硬化治疗日间管理模式的效果与安全性。方法 采用前瞻性随机对照研究设计,以2023年6月至2024年12月在中南大学湘雅二医院血管外科接受聚多卡醇泡沫剂注射治疗的VM患儿为研究对象,由家属自主选择治疗管理模式,并根据治疗管理模式分为日间治疗组(n=51)和住院治疗组(n=55)。比较两组患儿治疗效果、不良反应、术前焦虑评分、治疗费用和家属满意度。结果 日间治疗组和住院治疗组总有效率分别为92.2%和92.7%,差异无统计学意义(P>0.05);术后7 d内轻度不良反应发生率分别为37.3%和40.0%,差异无统计学意义(P>0.05);两组均无一例出现严重并发症。日间治疗组患儿术前焦虑评分较低［（35.8±3.73）分比（45.7±5.21）分］，治疗费用较低［（5 009.47±427.84）元比（7 159.78±549.10）元］，家属满意度评分更高［（21.49±1.64）分比（19.40±1.78）分］；上述指标差异均具有统计学意义(P<0.001)。结论 小儿VM硬化治疗日间管理模式与住院管理模式疗效与安全性相当,但日间管理模式可有效缓解患儿术前焦虑,减少治疗费用,提升家属满意度,具有良好的临床应用与推广价值。
- Abstract:
- Objective To evaluate the clinical efficacy and safety of sclerotherapy for pediatric venous malformations (VM) under a day-care model and compare it with conventional inpatient management in terms of preoperative anxiety,treatment expense and parental satisfaction. Methods Between June 2023 and December 2024,a prospective observational cohort study was conducted for 106 VM children on a sclerotherapy of polidocanol foam.They were assigned into two groups of day treatment (n=51) and inpatient management (n=55).Clinical efficacy,adverse events,preoperative anxiety scores,treatment expenses and parental satisfaction were compared. Results The overall treatment efficacy rate was 92.2% in day treatment group and 92.7% in inpatient group.There was no significant inter-group difference (P>0.05).The incidence of mild postoperative adverse events within 7 days was similar between two groups (37.3% vs. 40.0%) and no serious complications occurred (P>0.05).Preoperative anxiety scores were significantly lower in day treatment group than that in inpatient management group［(35.8±3.73) vs. (45.7±5.21),P<0.00］.Total treatment expense dropped markedly［(5 009.47±427.84) vs. (7 159.78±549.10) yuan,P<0.001］.Parental satisfaction scores were higher in day treatment group［(21.49±1.64) vs. (19.40±1.78),P<0.001］. Conclusions For pediatric VM,day polidocanol sclerotherapy is as effective and safe as inpatient management.The former offers extra benefits of reduced anxiety,lower expense and improved parental satisfaction.It represents a valuable alternative for clinical applications and broader implementations.
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备注/Memo
收稿日期:2025-8-6。
基金项目:湖南省科技厅医卫联合基金项目(2024JJ9216)
通讯作者:李杰华,Email:lijiehua@csu.edu.cn