摘要目的:探讨射频消融术治疗单侧膝关节腔内静脉畸形的价值。方法:回顾性分析郑州大学第三附属医院血管瘤外科2018年2月至2019年5月收治的15例膝关节腔内静脉畸形患者的病例资料，男7例，女8例，年龄5~25岁，平均16岁。均为单侧膝关节受累，病变范围从局限性病变到弥漫性广泛病变。选取工作尖端直径为0.5 mm的射频消融电极针，功率调至25 W。手术全程在彩色超声监控引导下，将工作尖端刺入距病变最底部即最深处约l mm处，通电消融10~30 s，其后依次退出电极针1 mm，直至距病变表面1 mm处，行多点消融，直至病变彻底消除。结果:本组15例均一期手术彻底消融病变，包括骨关节面及关节腔韧带和股骨下段、小腿上段肌肉内和皮肤的病变。术后随访6个月至1年，未见复发，膝关节外形与健侧膝关节基本对称，无瘢痕，外观满意。结论:应用射频消融术治疗膝关节腔内静脉畸形，病灶消融彻底，无明显并发症，预后良好，且外观美观，是一种有价值的微创手术方式。

abstractsObjective:To investigate the outcomes of therapeutic radiofrequency ablation (RFA) in unilateral intra-articular venous malformations (IAVMs) of the knee.Methods:The clinical data of 15 patients with intravascular venous malformation in the Third Affiliated Hospital of Zhengzhou University from February 2018 to May 2019 were retrospectively analyzed. There were 7 males and 8 females with an average age of 16 years (range, 5—25 years). All patients had unilateral knee involvement, ranging from localized lesions to diffuse extensive lesions. The radiofrequency ablation electrode needle with a diameter of 0.5 mm was selected and the power was adjusted to 25 W. Under the guidance of color ultrasound monitoring, the whole operation was carried out. The RFA electrode needle was inserted into the deepest site of the lesion and extracted by 1-mm graded movements until a point 1 mm from the surface of the lesion. Each ablation point was ablated for 10 to 30 seconds and multi-point ablation was done until the lesions were completely eliminated. Patients were followed up for 6 months to 1 year. Treatment outcomes were evaluated by functional activity, including extension, flexion, abduction, and adduction at the knee joint, and MRI findings, including intensity, shape, boundary, and degree of aggressiveness in the intra- and extraarticular cavities.Results:Included 15 patients; 12 had VMs in the knee joint cavity, and 3 had VMs involving both the intraarticular and extraarticular cavities (1 from the joint cavity to the calf, 1 from the joint cavity to the lower femur, and 1 from the intraarticular to the extraarticular cavity). All subjects underwent RFA, and the lesions were completely ablated and eradicated in a single operation. No recurrence was reported in the 6 months to 1 year follow-up. The knee joint remained symmetrical with the contralateral knee joint, without scarring, after the RFA.Conclusions:Radiofrequency ablation for the treatment of intra-articular venous malformation of the knee joint is a valuable minimally invasive surgical method with complete ablation, no complications, good prognosis and aesthetic appearance.