注意：泡沫硬化疗法治疗静脉曲张可并发微栓塞

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Foam Sclerotherapy for Varicose Veins Linked to Microembolism
April 3, 2008 — Researchers are reporting that microembolism of foam particles is common during foam sclerotherapy for varicose veins, and among patients with patent foramen ovale (PFO), these microemboli might be linked to neurologic symptoms.
研究人员发现在泡沫硬化疗法治疗静脉曲张过程中，泡沫颗粒引起的微栓塞是常见的并发症，并且在卵圆孔未闭的患者中，这些微栓子可引起神经症状。

The possible link is discussed in correspondence in the April 3 issue of the New England Journal of Medicine, by authors Roeland P.M. Ceulen, MD, and Anja Sommer, PhD, from the GROW School for Oncology and Developmental Biology, and Kevin Vernooy, MD, PhD, from the Cardiovascular Research Institute, both in Maastricht, the Netherlands.
(泡沫硬化疗法治疗静脉曲张可并发微栓塞)可能的相关联系，在4月3日的新英格兰医学期刊（NEJM）以通信的形式报道。作者分别是来自荷兰， Maastricht ，GROW 学院 肿瘤和发育生物(GROW School for Oncology and Developmental Biology) 的Roeland P.M. Ceulen, MD, 和 Anja Sommer, PhD,和心血管研究所(Cardiovascular Research Institute)的 Kevin Vernooy, MD, PhD,

After 2 index cases, a man with transient scotomas and a woman who developed a migraine attack immediately after the initiation of foam sclerotherapy treatment, the researchers undertook to monitor 33 such patients for the distribution of foam using echocardiography during the procedure.
文中报道了两个新的病例，在初始泡沫硬化疗法治疗后，一个男性患者出现短暂的视物暗点，另一个女性患者立即出现了偏头痛.

\"In all patients studied, we detected foam microemboli in both the right atrium and ventricle between 45 seconds and 15 minutes after foam injection,\" they write. \"In 5 patients, microembolism was also detectable in the left atrium and ventricle; however, neurologic signs did not develop in any of them.\"
”在研究的所有患者中，在泡沫注射后，在45秒到15分钟之间，我们可在右心房和右心室检测到泡沫微栓子“。他们报道，“其中有5个患者，在左心房和左心室也可检测到泡沫微栓子,但他们并没有出现神经症状。

Careful echo examination of these latter 5 patients showed each had a right-to-left shunt from a PFO, and subsequent examination of the 2 symptomatic index patients also revealed each had a PFO.
对这5个病人仔细的超声检查发现，每个病人都有卵圆孔未闭，而引起的右到左分流,随即检查出现症状的2个病例,也同时发现了卵圆孔未闭.

\"These findings suggest that foam-induced microembolism is a common phenomenon during foam sclerotherapy,\" the authors write. The prevalence of PFO in the population is about 26%, and serious neurologic complications associated with foam sclerotherapy are estimated to occur in 2% or less of patients, they note. The findings of their analysis are in line with these estimates.
“这些研究发现提示，泡沫引起的微栓子是泡沫硬化治疗中的常见现象”。作者报道。卵圆孔未闭在人群中的患病率是26%.泡沫硬化疗法治疗出现严重并发症的估计为2%,或更少。他们的研究结果与这些预测一致。

\"Nevertheless, we suggest that caution be exercised when foam sclerotherapy is performed in patients with a known patent foramen ovale and that patients with overt neurologic symptoms undergo additional echocardiographic examination for the presence of a patent foramen ovale,\" they conclude. \"Further prospective studies are needed to evaluate and confirm our observations.\"
“而且，我们建议对已知有卵圆孔未闭的患者用泡沫硬化疗法时需要谨慎，对出现明显神经症状的患者需进行附加的心脏超声检测，以明确是否有卵圆孔未闭存在。”他们总结说。“需要进一步的前瞻性研究来证明我们的发现。

N Engl J Med 2008;358:14.