先天性血管瘤误诊为婴幼儿血管瘤临床分析  

Clinical Analysis of Congenital Hemangioma Misdiagnosed as Infantile Hemangioma

作　　者：薛磊[1] 刘琪 高阳[1] 张蕴珍 王怡茗 周云[1] 张文显[1] XUE Lei;LIU Qi;GAO Yang;ZHANG Yun-zhen;WANG Yi-ming;ZHOU Yun;ZHANG Wen-xian(Department of Plastic Surgery,Hebei Children's Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院整形外科,石家庄050031

出　　处：《临床误诊误治》2022年第5期7-10,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题(20200641)。

摘　　要：目的探讨先天性血管瘤误诊为婴幼儿血管瘤的原因及防范措施。方法回顾性分析2011年1月-2020年1月误诊的先天性血管瘤8例的临床资料。结果本组误诊率为53.33%。本组因局部紫红色圆形肿物伴白晕,无明显变化入院4例;因局部紫红色肿物皮温高,表面散在毛细血管入院4例;均误诊为婴幼儿血管瘤,误诊时间为3~7(1.8±0.3)个月。8例规律应用普萘洛尔或糖皮质激素治疗后,效果欠佳,进一步行影像学及病理检查,证实为先天性血管瘤。确诊后4例给予局部压迫观察,疗程3~18个月,病情改善,病灶体积缩小;其余4例给予手术治疗,获得治愈。结论先天性血管瘤主要表现为局部紫红色圆形或卵圆形肿物,表面可见散在毛细血管扩张,有些病变周围可见白晕,临床误诊率较高。临床医生应加强对该病的认识,接诊高度怀疑先天性血管瘤患儿时,应仔细询问病史及查体,及早行相关影像学检查,确诊还需行病理检查。Objective To explore the causes and preventive measures of congenital hemangioma(CH)misdiagnosed as infantile hemangioma(IH).Methods Clinical data of 8 misdiagnosed patients with CH between January 2011 and January 2020 was retrospectively analyzed.Results The misdiagnosed rate in this group was 53.33%.Among the 8 patients,4 patients were admitted to hospital due to local purplish-red round mass with white halo and without obvious changes,while other 4 patients were admitted for local purplish-red mass with high skin temperature and scattered capillaries on the surface.All the patients were misdiagnosed as having IH,and the misdiagnosed duration was 3-7(1.8±0.3)months.Poorly clinical efficacy was found after treatments of Propranolol or Glucocorticoid regularly In the 8 patients,and then CH was confirmed after further imaging and pathological examinations.After confirming the diagnosis,4 patients were given local compression,and the course of treatment was 3 to 18 months,and then the conditions were improved and sizes of the lesions were decreased.The remaining 4 patients underwent surgery and were cured.Conclusion CH is mainly manifested as a local purplish-red round or oval mass with scattered telangiectasia on the surface,and white halo around some lesions,and the misdiagnosis rate is high in clinical practice.Clinicians should strengthen their understanding of the disease.Careful inquisition of medical history and physical examination,and timely relevant imaging examinations should be performed when receiving children with highly suspected CH.

关 键 词：先天性血管瘤 误诊 婴幼儿血管瘤 诊断 鉴别 

分 类 号：R732.2[医药卫生—肿瘤]