Wei Ying, Rong Zhihui, Gao Jinzhi, Chen Ling
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Pediatr. 2025 Apr 28;13:1453019. doi: 10.3389/fped.2025.1453019. eCollection 2025.
To investigate the clinical features, complications, diagnosis and management of congenital hepatic hemangiomas(CHHs).
12 neonates of CHH admitted to our hospital in the past 10 years were retrospectively analyzed, and the clinical manifestations, auxiliary examination results, diagnosis and treatment methods, clinical efficacy andprognosis were reviewed.
In this study, 12 neonates with CHHs were reported. Among them, 8 cases underwent surgical treatment and recovered well postoperatively. 3 cases received routine pharmacological treatment, were gradually recovering. Only one case, presenting with giant CHH and congestive heart failure (CHF) at birth, failed initial pharmacological treatment and underwent percutaneous hepatic hemangioma embolization but died postoperatively.
Large CHHs tend to be complicated with refractory congestive heart failure, likely due to tumor size and intra-tumor arteriovenous shunt. Propranolol is effective for CHHs with stable hemodynamics but has a slow onset of action, making it less suitable for cases complicated with CHF. Surgical resection is effective and recommended for large CHHs with stable hemodynamics, while percutaneous hepatic hemangioma embolization is advised for unstable cases.
探讨先天性肝血管瘤（CHHs）的临床特征、并发症、诊断及治疗方法。
回顾性分析我院近10年收治的12例CHH新生儿病例，对其临床表现、辅助检查结果、诊断及治疗方法、临床疗效及预后进行总结。
本研究共报告12例CHH新生儿。其中8例行手术治疗，术后恢复良好。3例行常规药物治疗，病情逐渐好转。仅1例出生时即表现为巨大CHH并伴有充血性心力衰竭（CHF），初始药物治疗无效，接受经皮肝血管瘤栓塞术，但术后死亡。
巨大CHHs易并发难治性充血性心力衰竭，可能与肿瘤大小及瘤内动静脉分流有关。普萘洛尔对血流动力学稳定的CHHs有效，但起效缓慢，不太适合并发CHF的病例。对于血流动力学稳定的巨大CHHs，手术切除有效且推荐使用；对于病情不稳定的病例，建议行经皮肝血管瘤栓塞术。
