产前诊断并宫内治疗胎儿巨大肝血管瘤1例  

Prenatal diagnosis and intrauterine treatment of a giant fetal hepatic hemangioma:a case report

作　　者：唐卉 杨朝湘[2] 李静姝 王伟 陈丹[3] 吴菁[1] Hui Tang;Chaoxiang Yang;Jingshu Li;Wei Wang;Dan Chen;Jing Wu(Prenatal Diagnosis Centre,Guangdong Women and Children Hospital,Guangzhou 511400,China;Radiology Department,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Ultrasonography,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院医学遗传中心,广州511400 [2]广东省妇幼保健院放射科,广州511400 [3]广东省妇幼保健院超声科,广州511400

出　　处：《中华围产医学杂志》2023年第4期331-334,共4页Chinese Journal of Perinatal Medicine

摘　　要：本文报道1例合并心脏增大的胎儿巨大肝血管瘤病例的宫内治疗。孕妇孕23周因“超声发现胎儿腹部异常回声(肝血管瘤?肝动静脉瘘畸形?)”转诊至广东省妇幼保健院。孕26周产前超声提示胎儿肝血管瘤增大至45 mm×35 mm×42 mm且合并心脏增大(心胸面积比0.50),故在孕妇及家属知情同意下联合普萘洛尔和地塞米松宫内给药并持续超声监测,用药初期肿块仍有增大,至药物治疗第7周肿块渐缩小、胎儿心脏负荷降低,病情得到控制,最终在37周顺利分娩。新生儿4日龄CT检查示腹部包块大小为40 mm×30 mm×44 mm,无需治疗,随访至1岁未见异常。This article reported a case of fetal giant hepatic hemangioma with cardiomegaly managed with intrauterine treatment.At 23 weeks of gestation,the patient was referred to Guangdong Women and Children Hospital due to abnormal abdominal echogenicity of the fetus,which was suspected to be a hepatic hemangioma or a hepatic arteriovenous fistula.The prenatal ultrasound at 26 weeks of gestation revealed an enlarged fetal hepatic hemangioma of 45 mm×35 mm×42 mm and an enlarged heart(cardiothoracic area ratio of 0.50).So,with the patient's informed consent,the fetus was treated with intrauterine administration of propranolol and dexamethasone and closely monitored by ultrasound.The volume of the lump still increased at the beginning of the medication,but started to shrink in the 7th week.Besides,the fetal cardiac load was reduced and the condition was controlled.The patient delivered at 37 weeks of gestation.The baby received a CT examination on the fourth day after birth which revealed an abdominal mass of 40 mm×30 mm×44 mm requiring no treatment,and no abnormalities were reported during a one-year follow-up.

关 键 词：肝肿瘤 血管瘤 产前诊断 胎儿期疗法 

分 类 号：R714.5[医药卫生—妇产科学]