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经导管动脉栓塞联合普萘洛尔口服治疗婴儿肝血管瘤的临床评价。

Clinical evaluation of transcatheter arterial embolization combined with propranolol orally treatment of infantile hepatic hemangioma.

机构信息

Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University Ji'nan Children's Hospital, Jinan, China.

Department of Vascular Anomalies and Interventional Radiology, Ji'nan Children's Hospital, Jinan, China.

出版信息

Pediatr Surg Int. 2022 Aug;38(8):1149-1155. doi: 10.1007/s00383-022-05143-w. Epub 2022 Jun 16.

Abstract

PURPOSE

To assess the efficacy of transcatheter arterial embolization (TAE) plus propranolol treatment for infantile hepatic hemangioma (IHH).

METHODS

A retrospective study of symptomatic IHH and hemodynamic changes in IHH was conducted between 2016 and 2019.

RESULTS

There were five boys and seven girls with diffuse lesions (n = 7) and multifocal lesions (n = 5). Hepatomegaly and abdominal distension (n = 6) were the predominant clinical presentations. Seven patients (58.3%) had multiple cutaneous hemangiomas. Pulmonary arterial hypertension, heart failure (n = 4), and hypothyroidism (n = 4) were observed. A total of 17 TAE procedures were performed in 12 IHH cases, with a technical success rate of 100%. All patients received standard propranolol orally, and one patient was orally administered metacortandracin. Two patients died of heart failure and multiple organ dysfunction caused by an enlarged liver. In addition, one patient was not reexamined after discharge. Of the remaining nine children, the average follow-up time was 10.78 months (range 2-28 months), and they all responded well to TAE combined with oral propranolol.

CONCLUSION

TAE combined with propranolol is safe and effective for the treatment of IHH, demonstrating low complication rates.

摘要

目的

评估经导管动脉栓塞(TAE)联合普萘洛尔治疗婴儿肝脏血管瘤(IHH)的疗效。

方法

对 2016 年至 2019 年间患有症状性 IHH 和 IHH 血流动力学变化的患者进行回顾性研究。

结果

7 例为弥漫性病变(n=7),5 例为多灶性病变(n=5)。肝肿大和腹胀(n=6)是主要的临床表现。7 例患者(58.3%)有多个皮肤血管瘤。观察到肺动脉高压、心力衰竭(n=4)和甲状腺功能减退(n=4)。12 例 IHH 中有 17 例行 TAE 治疗,技术成功率为 100%。所有患者均接受标准普萘洛尔口服治疗,1 例患者口服甲泼尼龙。2 例患者因肝肿大导致心力衰竭和多器官功能障碍而死亡。此外,1 例患者出院后未复查。其余 9 例患儿平均随访时间为 10.78 个月(2-28 个月),均对 TAE 联合口服普萘洛尔治疗反应良好。

结论

TAE 联合普萘洛尔治疗 IHH 安全有效,并发症发生率低。

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