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动静脉畸形(arteriovenous malformations,AVMs)是由于胚胎期脉管系统发育异常而导致动、静脉直接吻合所形成的血管团块,内含不成熟的动脉和静脉,而且血管团块中没有毛细血管,动静脉之间存在不同程度的直接交通。在血管瘤与血管畸形中,动静脉畸形相对少见,仅占1.5%左右,口腔颌面部是最好发的部位,占所有动静脉畸形的50%,其次是四肢和躯干。尽管动静脉畸形是先天性疾病,但仅有约60%是在出生时即被发现,其余在青春期或成年后才逐渐显现。病灶通常随身体发育而呈比例增长,可长期保持稳定,也可在短期内迅速增大,这种情况通常出现在外伤、青春期或孕期体内激素变化及不恰当的治疗,如病灶的次全切除、供血动脉结扎或堵塞之后。介入栓塞是目前主要的治疗方法,介入栓塞成功的关键是输送器进入异常血管团的中央以及选用可破坏血管内皮细胞的栓塞剂。本文参考国内外相关文献和诊治经验,制定口腔颌面部动静脉畸形治疗指南,希望对口腔颌面部动静脉畸形的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,为广大患者提供最新治疗方案。
Arteriovenous malformations (AVMs) are vascular clumps formed by direct anastomotic venous anomalies resulting from the abnormal development of the vasculature in the embryo. They contain immature arteries and veins, and there are no capillaries in the clumps. There are different degrees of direct traffic between the arteries and veins. In hemangiomas and vascular malformations, arteriovenous malformations are relatively rare, only about 1.5%, oral and maxillofacial region is the best hair site, accounting for 50% of all arteriovenous malformations, followed by the limbs and trunk. Although arteriovenous malformations are congenital diseases, only about 60% are found at birth, and the rest gradually appears after puberty or adulthood. Focal lesions usually grow in proportion to body growth, which can be stable over the long term, but also rapidly increase in the short term. This usually occurs during traumatic, adolescent or pregnancy hormone changes and inappropriate treatment such as subtotal resection of the lesion After the feeding artery ligation or blockage. Interventional embolization is the main treatment, the key to the success of interventional embolization is the conveyor into the center of abnormal vascular groups and the selection of embolization agents that can damage the vascular endothelial cells. In this paper, reference to relevant literature and diagnosis and treatment of domestic and foreign experience in the development of guidelines for the treatment of oral and maxillofacial arteriovenous malformations, hoping to regulate the treatment of oral and maxillofacial arteriovenous malformations play a guiding role. This guidebook will be updated in a timely manner to reflect and incorporate the latest research findings and to provide the vast majority of patients with the latest treatment options.