AbstractObjectiveTo analyze the sclerotherapy of giant (≥8 mm) lymphatic malformations in neonates and discuss effective treatment.MethodsThis was a single-center retrospective study. Twelve patients received bleomycin (BLM) (six patients) or BLM combined with polidocanol (POL) (eight patients). The safety and effects of BLM and BLM + POL were analyzed using a t-test for categorical data and likelihood ratios or Fisher’s exact test for continuous data.

目的分析新生儿巨大（≥8mm）淋巴管畸形的硬化治疗方法，探讨有效的治疗方法。方法这是一项单中心回顾性研究。12名患者接受博来霉素（BLM）（6名患者）或BLM联合polidocanol（POL）（8名患者）。使用分类数据和似然比的t检验或连续数据的Fisher精确检验分析BLM和BLM+ POL的安全性和效果。

Factors resulting in an increased number of treatment sessions were studied.ResultsTreatment began 2–5 days after birth. The patients in the BLM group underwent more treatment sessions. Gestational age, lesion size and type, total response, and complications showed no significant differences between groups.

研究了导致治疗次数增加的因素。结果治疗在出生后2-5天开始。BLM组的患者接受了更多的治疗。胎龄，病变大小和类型，总反应和并发症在组间无显着差异。

Larger and mixed-ype lesions required more treatment sessions.ConclusionsBoth BLM group and BLM + POL group appear relatively safe and effective in neonates with giant lymphatic malformations. The combination of the two agents reduced the number of procedures and general anesthesia required..

较大和混合型病变需要更多的治疗疗程。结论BLM组和BLM+POL组治疗新生儿巨大淋巴管畸形安全有效。两种药物的联合使用减少了手术次数和所需的全身麻醉。。

IntroductionLymphatic malformations (LMs) are vascular malformations that result from the abnormal development of the lymphatic system during the embryonic period [1]. LMs are divided into three morphological types: macrocystic, microcystic, and mixed [2]. LMs can occur in any region; however, the neck is the most common location.

引言淋巴管畸形（LMs）是由胚胎期淋巴系统异常发育引起的血管畸形。LMs分为三种形态类型：大囊性，微囊性和混合型（2）。LMs可以发生在任何地区；然而，颈部是最常见的位置。

Patients with giant LMs often face several risks during the newborn stage. The most severe complication is airway compression, including that of the larynx and trachea, especially in patients with spontaneous hemorrhage [3, 4]. In addition, infection and subsequent abscesses may occur in LM cysts [5].Although spontaneous regression has been observed in some LMs, giant LMs require treatment even in neonates because of their high risk of compression.

巨大LMs患者在新生儿期经常面临多种风险。最严重的并发症是气道压迫，包括喉和气管压迫，尤其是自发性出血患者[3，4]。此外，LM囊肿可能发生感染和随后的脓肿（5）。虽然在一些LMs中观察到自发消退，但巨大的LMs甚至在新生儿中也需要治疗，因为它们有很高的压迫风险。

Therapies for LMs include sclerotherapy, surgery, and systemic drugs [6,7,8]. Considering its minimal injury, effectiveness, and low complication rates, sclerotherapy has been regarded as the optimal choice in recent years, particularly for macrocystic lesions. However, neonatal treatment remains challenging.

LMs的治疗包括硬化疗法，手术和全身药物[6,7,8]。考虑到其最小的损伤，有效性和低并发症发生率，硬化疗法近年来被认为是最佳选择，特别是对于大囊性病变。然而，新生儿治疗仍然具有挑战性。

Neonates, especially preterm babies and early neonates, face a higher risk of anesthesia and other possible complications during the perinatal period. Giant and multi-cystic lesions often require higher drug doses; however, the low body weight and immature liver and renal function of neonates restrict the drug type and dosage.

新生儿，尤其是早产儿和早期新生儿，在围产期面临较高的麻醉风险和其他可能的并发症。巨大和多囊性病变通常需要更高的药物剂量；然而，新生儿体重低和肝肾功能不成熟限制了药物的类型和剂量。

The optimal choice of sclerosants for neonates remains unclear.This study aimed to analyze sclerotherapy for giant LMs in neonates, identify the possible factors that may affect the outcome, and discuss the treatment strategy for this disease in neonates.MethodsPatients and clinical dataFourteen patients with LMs >8 cm at the West China Second University Hospital of Sichu.

新生儿硬化剂的最佳选择仍不清楚。本研究旨在分析新生儿巨大LMs的硬化疗法，确定可能影响结局的可能因素，并讨论新生儿该疾病的治疗策略。方法患者和临床数据四川华西第二大学医院14例LMs>8 cm的患者。

Data availability

数据可用性

All data generated or analyzed during this study are included in this published article.

本研究期间生成或分析的所有数据均包含在本文中。

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Download referencesFundingNational Natural Science Foundation of China, Grant Number: 82102897.Author informationAuthors and AffiliationsDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaFan Hu, Fan Ma & Xiaoliang LiuKey Laboratory of Birth Defect and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, ChinaFan Hu, Fan Ma & Xiaoliang LiuDepartment of Radiotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, ChinaJiayun YuAuthorsFan HuView author publicationsYou can also search for this author in.

下载参考文献资助国家自然科学基金，资助号：82102897。作者信息作者及所属单位四川大学华西第二大学医院儿科，四川成都，中国四川省成都市，胡凡、马凡和刘晓良教育部出生缺陷及相关疾病重点实验室（四川大学），四川省成都市，胡凡、马凡和刘晓良四川大学华西医院生物治疗国家重点实验室肿瘤中心放射治疗科，中国成都，余家云作者胡凡观点作者出版物您也可以在中搜索该作者。

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PubMed Google ScholarContributionsFH designed the study and drafted the manuscript; XL collected the data; FM participated in the writing of the manuscript; JY helped statistical analysis, revised the manuscript and provided the funding.Corresponding authorCorrespondence to

PubMed Google ScholarContributionsFH设计了这项研究并起草了手稿；XL收集了数据；FM参与了手稿的撰写；JY帮助进行统计分析，修改稿件并提供资金。对应作者对应

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Competing interests

相互竞争的利益

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作者声明没有利益冲突。

Ethical approval

道德认可

The patients’ parents provided informed consent, including permission to use their clinical data. The authors have obtained written informed consent for publication of the images of the patients. This study was approved by the ethics committee of West China Second University Hospital of Sichuan University.

患者父母提供了知情同意书，包括使用其临床数据的许可。作者已获得书面知情同意书，以发布患者的图像。本研究经四川大学华西第二大学医院伦理委员会批准。

This study followed the ethical guidelines of the Declaration of Helsinki..

这项研究遵循了《赫尔辛基宣言》的道德准则。。

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Reprints and permissionsAbout this articleCite this articleHu, F., Ma, F., Liu, X. et al. Sclerothrapy of giant lymphatic malformation in neonates.

转载和许可本文引用本文Hu，F.，Ma，F.，Liu，X。等人。新生儿巨大淋巴管畸形的硬化疗法。

J Perinatol (2024). https://doi.org/10.1038/s41372-024-02113-zDownload citationReceived: 10 March 2024Revised: 26 August 2024Accepted: 05 September 2024Published: 23 September 2024DOI: https://doi.org/10.1038/s41372-024-02113-zShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

J Perinatol（2024）。https://doi.org/10.1038/s41372-024-02113-zDownload引文收到日期：2024年3月10日修订日期：2024年8月26日接受日期：2024年9月5日发布日期：2024年9月23日OI：https://doi.org/10.1038/s41372-024-02113-zShare本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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