新生儿肝脏血管瘤的临床诊治分析

目的总结新生儿肝脏血管瘤的临床特点,指导临床诊断和治疗。方法回顾性分析16例新生儿肝血管瘤的临床资料,并结合文献加以讨论。结果 16例新生儿肝脏血管瘤患儿中,7例手术完整切除,近期1例出现胆瘘,1例出现呼吸衰竭,远期并发症随访期间尚未发现,手术效果良好,术后随访3～36个月,复查肿瘤均未复发,肝功能及AFP恢复正常;9例未行手术进行临床动态观察,随访3～36个月,复查肿瘤逐渐增大。所有患儿生长发育同正常儿。结论新生儿肝脏血管瘤应根据患者病情选择个体化治疗方案,如术前能明确诊断,肿瘤较小、且无症状者可密切随访;如瘤体巨大、凝血功能异常、肝功能异常者,应早期手术治疗。

Clinical Diagnosis and Treatment of Neonatal Hepatic Hemangioma

Objective To summarize the clinical characteristics of neonatal hepatic hemangioma,and to guide the clinical diagnosis and treatment. Methods The clinical data of 16 cases of neonatal hepatic hemangioma were retrospectively analyzed. The related literatures were reviewed. Results Total resection was done in the 7 cases of the16 cases of neonatal hepatic hemangioma,and bile leak was found in the 1 case and respiratory failure was found in the 1 cases,there was no long-term complications during the follow-up period,the results of surgical treatment were satisfactory,all the cases were followed up without recurrence,hepatic function and AFP were back to normal with follow-up continued from 3 months to 36 months. About the rest 9 cases without performed operative treatment,the tumor size increased as the time lengthen during the follow-up period. The growth of all the patients had been in normal. Conclusion The selection of individualized treatment is based on the specific circumstances,such as close follow-up was treated if it was clearly diagnosed and the tumor was small without any symptoms,while early surgical operation is the key point if the tumor was giant,and with coagulation disorder and abnormal liver function.