Draper Haley, Diamond Ivan R, Temple Michael, John Philip, Ng Vicky, Fecteau Annie
Division of General Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Surg. 2008 Jan;43(1):120-5; discussion 126. doi: 10.1016/j.jpedsurg.2007.09.030.
To examine the results of the multimodal management of patients with endangering hepatic hemangioma associated with systemic compromise.
Retrospective descriptive case series of children with endangering hepatic hemangioma managed at our institution between January 1996 and June 2006.
Six children (5 females) presented with endangering hepatic hemangioma with systemic effects during the index time period. Mean age at presentation was 1.9 months (range, 2 days to 4 months). All patients received medical treatment, and all patients also underwent hepatic embolization, with a median number of procedures of 2 (range, 1-6). Two patients died, one of sepsis and one of progressive liver failure in a child presenting with advanced liver disease owing to neonatal hemochromatosis that was unrecognized at the time. The remaining 4 patients all recovered and were discharged. With mean postprocedure follow-up of 2.11 years (range, 0-6.2 years), all remain well.
Multimodal management of endangering hepatic hemangioma is a strategy that deserves consideration in the management of these patients. Although the strategy requires further evaluation as to its safety and efficacy, the procedure has the potential to decrease the need for liver transplantation because of treatment failures in this population.
探讨危及生命的肝血管瘤合并全身功能障碍患者的多模式治疗结果。
回顾性描述性病例系列研究，纳入1996年1月至2006年6月在我院接受治疗的危及生命的肝血管瘤患儿。
在研究期间，6名儿童（5名女性）出现危及生命的肝血管瘤并伴有全身影响。就诊时的平均年龄为1.9个月（范围为2天至4个月）。所有患者均接受了药物治疗，并且均接受了肝动脉栓塞术，手术次数中位数为2次（范围为1 - 6次）。2名患者死亡，1名死于败血症，另1名死于进行性肝功能衰竭，该患儿因新生儿血色素沉着症导致晚期肝病，当时未被识别。其余4名患者均康复出院。术后平均随访2.11年（范围为0 - 6.2年），所有患者情况良好。
危及生命的肝血管瘤的多模式治疗是这些患者治疗中值得考虑的一种策略。尽管该策略的安全性和有效性需要进一步评估，但该手术有可能减少因该人群治疗失败而进行肝移植的需求。
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