儿童肝脏血管瘤的介入治疗方法及疗效的初步探讨

目的探索儿童肝脏血管瘤的介入治疗方法及疗效。 方法回顾性分析我院31例实施肝脏血管瘤介入治疗患者的临床资料。年龄6 d至9岁;先天型肝脏血管瘤26例,婴儿型肝脏血管瘤5例;肝脏多发病变5例,单发病变26例。所有患者均接受CT平扫、CT增强扫描以及肝脏血管瘤硬化栓塞术。依据患者治疗前后CT影像学表现,分析肝脏血管瘤硬化栓塞术对不同分型患者治疗疗效。采用配对样本t检验分别比较婴儿型及先天型肝血管瘤介入治疗术前、术后体积差异。 结果23例接受单次介入治疗,6例接受2次介入治疗,2例接受3次介入治疗。26例患儿接受随访,包括先天型肝血管瘤23例,婴儿型肝血管瘤3例。11例瘤体完全消失,患儿完全康复,15例瘤体部分缩小（4例缩小70%以上,效果显著;6例缩小30%~50%,部分有效;5例缩小低于30%,效果欠佳）。先天型肝血管瘤术前、术后平均体积分别为（161.86 ± 21.40）cm³、（41.46 ± 9.73）cm³,婴儿型肝血管瘤术前、术后平均体积分别为（22.73 ± 1.92）cm³、（11.18 ± 3.18）cm³,术前、术后体积差异均具有统计学意义（P < 0.001）。 结论肝脏血管瘤硬化栓塞术是一种安全、有效的微创治疗方法,对儿童肝脏血管瘤治疗效果较好,且术前分型是儿童肝脏血管瘤介入治疗疗效的重要因素。

A preliminary study on interventional treatment methods and therapeutic effects for hepatic hemangioma in children

ObjectiveTo explore interventional treatment methods and therapeutic effects of interventional therapy for hepatic hemangioma in children. MethodsThe clinical data of 31 children underwent interventional therapy for hepatic hemangioma in Beijing Children's Hospital from January 2016 to January 2019 were retrospectively analyzed. The patients are ranging in age from 6 days to 9 years old. Including 26 cases of congenital hepatic hemangiomas, 5 cases of infantile hepatic hemangiomas, and imaging examination showed 5 cases of multiple liver lesions and 26 cases of single liver lesions. All children received plain CT scan, enhanced CT scan and embolization sclerotherapy for hepatic hemangioma. CT findings before and after interventional embolization were used to analyze the efficacy of embolization sclerotherapy for hepatic hemangioma in different types of children. The paired sample t test was used to compare the volume differences of the infantile and congenital hemangioma lesions before and after interventional therapy. Results23 cases received single interventional therapy, 6 received two interventional therapy, and2 received three interventional therapy. 26 cases in total 31 patients were followed up, including 23 congenital hepatic hemangioma and 3 infant hepatic hemangioma. The tumors disappeared completely in 11 children and the children recovered completely, while the tumors were partially reduced in 15 children (4 cases reduced by more than 70%, the effect was significant; 6 cases reduced by 30%~50%, partially effective; 5 cases reduced less than 30%, the effect was not obvious). The mean preoperative and postoperative volumes of congenital hemangioma were (161.86 ± 21.40) cm³ and (41.46 ± 9.73) cm³, and the mean preoperative and postoperative volumes of infantile hemangioma were (22.73 ± 1.92) cm³ and (11.18 ± 3.18) cm³. The preoperative and postoperative volume differences for congenital hemangioma and infantile hemangioma were all statistically significant (P < 0.001). ConclusionsEmbolization sclerotherapy of hepatic hemangioma is a safe and effective minimally invasive treatment for hepatic hemangioma in children,and preoperative classification is an important factor in the efficacy of interventional therapy for pediatric hepatic hemangioma in children.