| 摘要: |
| 3岁患儿因“扪及右上腹肿块”就诊，超声及CT检查均示右肝肝母细胞瘤伴门静脉、脾静脉内癌栓形成。因无手术指征，多学科会诊建议超声引导下穿刺活检。遂在全身麻醉下行超声引导下肝肿块穿刺活检。术后病理诊断为肝母细胞瘤。术后第4天，患儿突发剧烈腹痛，腹穿出不凝血，在血管内栓塞及输血等治疗后恢复良好。建议对低龄患儿术前严格控制手术指征，术中延长穿刺点压迫、通过同轴针内注射止血药物及术后延长制动时间以减少严重出血的风险。 |
| 关键词: 肝穿刺活检 超声引导 肝母细胞瘤 术后严重并发症 个案 |
| DOI： |
| 投稿时间：2022-10-11修订日期：2022-11-25 |
| 基金项目: |
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| Delayed severe bleeding after ultrasound-guided needle biopsy of hepatoblastoma in children：a case report |
| wangyunhan,yangjie,luqiang |
| () |
| Abstract: |
| The 3-year-old patient went to the doctor for "palpating the right upper abdominal mass". Ultrasound and CT examination showed right hepatoblastoma with tumor thrombus in portal vein and splenic vein. As there is no indication for surgery, multidisciplinary consultation suggests ultrasound guided puncture biopsy. Therefore, ultrasound guided liver mass biopsy was performed under general anesthesia. Postoperative pathological diagnosis was hepatoblastoma. On the 4th day after operation, the child suffered from acute abdominal pain, and did not clot after abdominal perforation. He recovered well after intravascular embolization and blood transfusion. It is suggested to strictly control the surgical indications for young children before operation, extend the pressure of puncture points during operation, inject hemostatic drugs through coaxial needles and extend the braking time after operation to reduce the risk of severe bleeding. |
| Key words: Delayed severe bleeding Ultrasound-guided needle biopsy Hepatoblastoma Case |
