经动脉介入栓塞治疗不同血供类型的婴幼儿肝血管瘤效果及其影响因素分析  

Analysis of the effect and influence factors of transarterial embolization in the treatment of infantile hepatic hemangioma with different blood supply types

作　　者：梅国勋[1] 孙静涛[1] 杨琦 李光民[1] MEI Guoxun;SUN Jingtao;YANG Qi;LI Guangmin(Department of Radiology,Tangshan Maternal and Child Health Hospital,Tangshan 063003,China)

机构地区：[1]唐山市妇幼保健院放射科,唐山063003

出　　处：《中国小儿血液与肿瘤杂志》2023年第5期283-287,共5页Journal of China Pediatric Blood and Cancer

基　　金：河北省2019年度医学科学研究课题计划项目(20191546)。

摘　　要：目的 探讨经动脉介入栓塞治疗不同血供类型的婴幼儿肝血管瘤(IHH)效果及疗效影响因素。方法 回顾分析2019年1月—2022年12月在我院诊治的108例IHH患儿资料,其中肿瘤直径<5 cm且无明显不良症状的患儿14例行保守治疗,肿瘤直径≥5 cm的患儿94例拟行动脉介入栓塞治疗。根据肿瘤供血类型不同将行介入治疗的患儿分为富血供型(n=34)、中等血供型(n=40)和乏血供型(n=20)。随访至术后6个月,比较不同供血类型的治疗效果。根据治疗效果将患儿分为有效组(n=63)和无效组(n=31),采用多因素Logistic回归分析法分析导致IHH治疗无效的危险因素。结果 不同血供组的缓解率比较,差异有显著性(P<0.05),中等血供组、富血供组之间比较,差异无显著性(P>0.05),乏血供组缓解率显著小于其他两组(P<0.05);富血供组、中等血供组、乏血供组的瘤体缩小率和动脉期强化比率缩小率依次减少(P<0.05)。无效组的肿瘤数目≥2个、肿瘤供血动脉多支、乏血供型、多次介入、无超选插管患儿占比大于有效组(P<0.05)。多因素Logistic回归分析显示,肿瘤数目≥2个、肿瘤供血动脉多支及乏血供型是导致肝血管瘤治疗无效的危险因素(P<0.05)。结论 与乏血供型相比,富血供型和中等血供型IHH经动脉介入栓塞治疗后疗效更佳;肿瘤数目≥2个、肿瘤供血动脉多支及乏血供型是导致IHH治疗无效的危险因素。Objective To explore the effects of transarterial embolication in the treatment of infantile hepatic hemangioma(IHH)with different blood supply types and the influencing factors.Methods The data of 108 children with IHH diagnosed and treated in our hospital from January 2019 to December 2022 were retrospectively analyzed.Among them,14 children with tumor diameter<5 cm and no obvious adverse symptoms received conservative treatment,and 94 children with tumor diameter≥5 cm were intended to receive arterial interventional embolization.According to different tumor blood supply types,the children receiving interventional therapy were divided into rich blood supply type(n=34),medium blood supply type(n=40)and deficient blood supply type(n=20).The therapeutic effects of different blood supply types were compared after 6 months of follow-up.According to the treatment effect,the children were divided into effective group(n=63)and ineffective group(n=31).Multivariate Logistic regression analysis was used to analyze the risk factors leading to ineffective treatment of IHH.Results The remission rate of different blood supply groups was statistically significant(P<0.05),while there was no statistically significant difference between the moderate blood supply group and the rich blood supply group(P>0.05).The remission rate of the lack blood supply group was significantly lower than the other two groups(P<0.05).The reduction rate of tumor shrinkage and the rate of arterial reinforcement in the rich blood supply group,the medium blood supply group and the lack blood supply group were decreased successively(P<0.05).The number of tumors≥2,multiple blood supply arteries,lack of blood supply type,multiple intervention,no super selective intubation accounted for a greater proportion of children in the ineffective group than the effective group(P<0.05).Multivariate Logistic regression analysis showed that the number of tumors≥2,multiple blood supply arteries and lack of blood supply type were risk factors for ineffective treatme

关 键 词：肝血管瘤 婴幼儿 动脉介入栓塞术 血供类型 疗效 

分 类 号：R735.7[医药卫生—肿瘤]