Hôpital Necker-Enfants-malades, Hepatogastroenterology-nutrition unit, 149, rue de Sèvres, 75015 Paris, France.
Clin Res Hepatol Gastroenterol. 2012 Jun;36(3):308-10. doi: 10.1016/j.clinre.2012.03.025. Epub 2012 Apr 25.
Liver cancers in children are primitive (hepatoblastoma, fibrolamellar hepatocarcinoma, sarcomas), or arise on a genetic or viral disease. Their treatment is a combination of chemotherapy (hepatoblastoma) and surgery. Neonatal hemangioendotheliomas may induce heart failure. They are now successfully treated with propranolol. Focal nodular hyperplasia is the most frequent benign tumour in older children and adolescents. Drug hepatotoxicity is not very frequent. Antipyretic drugs may induce severe side effects. Liver failure due to valproic acid is diagnostic of a respiratory chain disorder. The liver side effects of antituberculous and antiretroviral drugs should be monitored. Intestinal failure-associated liver disease is common and can be prevented or treated. Early referral to a specialized centre is important for the prognosis.
儿童肝癌有原发性的(肝母细胞瘤、纤维板层肝细胞癌、肉瘤),也有在遗传或病毒性疾病基础上发生的。其治疗方法是化疗(肝母细胞瘤)与手术相结合。新生儿血管内皮细胞瘤可导致心力衰竭。普萘洛尔现已成功用于治疗该病。局灶性结节性增生是年龄较大的儿童和青少年中最常见的良性肿瘤。药物性肝毒性并不常见。解热镇痛药可能会引起严重的副作用。丙戊酸引起的肝衰竭提示存在呼吸链障碍。应监测抗结核和抗逆转录病毒药物的肝脏副作用。肠衰竭相关肝病很常见,可预防或治疗。尽早向专门中心转诊对预后很重要。