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婴幼儿血管瘤的流行病学、发病机制、临床特点和并发症

Author
Denise W Metry, MD
Section Editor
Moise L Levy, MD
Deputy Editor
Rosamaria Corona, MD, DSc
Translators
吴严, 主任医师，教授

引言

婴儿和儿童的血管病变分为两大类：肿瘤和血管畸形[1]。婴幼儿血管瘤是最常见的血管肿瘤。其他血管瘤包括化脓性肉芽肿、卡波西样血管内皮瘤和丛状血管瘤等。人们所称的快速退化型先天性血管瘤(rapidly involuting congenital hemangiomas, RICH)和非退化型先天性血管瘤(non-involuting congenital hemangiomas, NICH)在组织病理学上貌似为杂交体，既有血管肿瘤的特点，也有血管畸形的特点。因为有过RICH演变为NICH的病例报道，有人提出RICH与NICH属于同一疾病谱范畴[2,3]。

婴幼儿血管瘤的特点是有一个生长期和一个退化期。与之相对，血管畸形可随儿童成长而相应增大，通常并不退化。血管畸形是源于毛细血管、动脉、静脉、淋巴管的结构异常或上述异常的组合。血管畸形将单独讨论。 (参见“新生儿血管病变”)

尽管婴幼儿血管瘤是良性的并具有自限性，但部分血管瘤可引起溃疡和永久性损容等并发症。此外，有的血管瘤可能损害重要的器官功能，或预示脊柱、中枢神经系统、循环系统和/或眼部的潜在发育异常。肝脏、脑部或消化道的血管瘤可能会引起危及生命的并发症，但这种情况较少见。血管瘤面积较大、位于面部和/或呈节段性形态是短期结局(以并发症发病率和治疗率测定)不佳最常见的预测指标[4]。 (参见下文‘节段性血管瘤’)

本文将概述婴幼儿血管瘤的流行病学、发病机制、临床特点和并发症。婴幼儿血管瘤的评估与治疗将单独讨论。 (参见“婴儿血管瘤的评估与诊断”和“婴儿血管瘤的处理”)

流行病学

血管瘤是婴儿期最常见的肿瘤。婴幼儿血管瘤的真实发病率尚不清楚[5]。虽然传统上认为该病在白种人婴儿中的发病率高达10%[6,7]，但估值为4%-5%可能更为准确[5,8]。婴幼儿血管瘤常在出生后数天到数月内被发现[9,10]。尽管多数血管瘤为散发性的，但也有过家族常染色体显性遗传的报道[11]。

                        

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Literature review current through: 2017-07 . | This topic last updated: 2017-07-06.
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