新生儿及小婴儿肝脏婴儿型血管内皮瘤的诊断和治疗探讨  

Diagnosis and treatment of infantile hepatic hemangioendothelionm in infants and young children

作　　者：杜京斌[1] 陈永卫[1] 祝秀丹[1] 郭卫红[1] 候大为[1] 李樱子[1] 刘翔[2] 

机构地区：[1]首都医科大学附属北京儿童医院外科,100045 [2]安徽省儿童医院

出　　处：《中华小儿外科杂志》2014年第12期915-917,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨新生儿及小婴儿肝脏婴儿型血管内皮瘤的诊断及治疗方法。方法回顾性分析2006年10月至2012年12月病房及门诊诊断的62例婴幼儿儿肝脏血管内皮瘤的临床资料。其中，手术治疗22例，口服激素治疗34例，不治疗随诊观察6例。结果手术组22例患儿全部存活。19例术后随诊至24个月，无复发，患儿生长发育同正常儿。激素治疗34例，随访3～6个月可见4例肿瘤缩小至2cm以下，2例肿瘤无明显变化。随访至患儿服药后6～12个月可见34例CT显示28例肿瘤消失，6例直径明显缩小至2cm以下，其中4例肝脏多发血管瘤均可见侵犯范围及数量减少。随诊观察6例，随访6～12个月可见4例肿瘤缩小至1cm以下，2例肿瘤无明显变化。结论对于IHHE的治疗根据病变部位及范围可采用不同的治疗方法。Objective To explore the diagnosis and treatment of infantile hepatic hemangioendothelioma （IHHE） in infants and young children. Methods The clinical data of 2006-2012 were retrospectively reviewed for 62 hospitalized cases of hepatic infantile hemangioendothelioma confirmed by postoperative pathology. And the treatments included surgery （n = 22）, oral corticosteroid （n = 34） and passive observation （n = 6）. Results All of them survived postoperatively. And 19 cases had normal growth and development and there was no recurrence during a follow-up period of 24 months. In the non-surgical group, after 3-6 months of corticosteroids, computed tomography （CT） scan showed that 28 cases were cured and tumor diameter significantly shrank under 2 cm in 6 cases, including multiple liver hemangioma downsized in infiltrated areas （n = 4）. For observation cases, tumor diameter decreased under 1 cm （n = 4） and there was no obvious change （n = 2） during a follow-up period of 3-6 months. Conelusions Based upon lesion sites and extents, IHHE may be treated differently with a fair prognosis.

关 键 词：血管内皮瘤 肝 婴儿 

分 类 号：R735.7[医药卫生—肿瘤]