中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2011年
1期
24-26
,共3页
戴鲁飞%张友乐%田光磊%熊革
戴魯飛%張友樂%田光磊%熊革
대로비%장우악%전광뢰%웅혁
血管球瘤%诊断%外科手术
血管毬瘤%診斷%外科手術
혈관구류%진단%외과수술
Glomus tumor%Diagnosis%Surgical procedures,operative
目的 分析甲外血管球瘤诊断与治疗的相关因素.方法 对2005年1月至2009年12月手术治疗的22例甲外血管球瘤进行回顾性分析.22例中,男女比例为1∶1.75(8∶14),年龄为24～63岁(平均39.4岁),发病至手术时间为3个月至28年(平均84.8个月).血管球瘤位于指腹17例(占77.3%,17/22),指近节掌侧2例(占9.1%,2/22),手掌2例(占9.1%,2/22),内踝1例(占4.5%,1/22).其中多发瘤2例(占9.1%,2/22),外伤史2例(占9.1%,2/22),可及肿物9例(占40.9%,9/22),Love试验阳性22例(占100%,22/22),冷敏感试验阳性7例(占31.8%,7/22).临床误诊12例(占54.5%,12/22),B超发现率22例(占100%,22/22).血管球瘤平均直径为4.1 mm(2.0～7.0 mm).结果 22例术后随访时间为4～144个月,其中19例(占87.4%,19/22)术后痊愈,自发痛及触痛消失.肿瘤复发3例(占13.6%,3/22),再次术后未见复发.结论 甲外血管球瘤缺乏典型的症状体征,诊断困难,提高对血管球瘤的认识,运用Love试验及高频B超,可有效地避免误、漏诊.完整切除肿瘤可以获得明确的疗效.
目的 分析甲外血管毬瘤診斷與治療的相關因素.方法 對2005年1月至2009年12月手術治療的22例甲外血管毬瘤進行迴顧性分析.22例中,男女比例為1∶1.75(8∶14),年齡為24～63歲(平均39.4歲),髮病至手術時間為3箇月至28年(平均84.8箇月).血管毬瘤位于指腹17例(佔77.3%,17/22),指近節掌側2例(佔9.1%,2/22),手掌2例(佔9.1%,2/22),內踝1例(佔4.5%,1/22).其中多髮瘤2例(佔9.1%,2/22),外傷史2例(佔9.1%,2/22),可及腫物9例(佔40.9%,9/22),Love試驗暘性22例(佔100%,22/22),冷敏感試驗暘性7例(佔31.8%,7/22).臨床誤診12例(佔54.5%,12/22),B超髮現率22例(佔100%,22/22).血管毬瘤平均直徑為4.1 mm(2.0～7.0 mm).結果 22例術後隨訪時間為4～144箇月,其中19例(佔87.4%,19/22)術後痊愈,自髮痛及觸痛消失.腫瘤複髮3例(佔13.6%,3/22),再次術後未見複髮.結論 甲外血管毬瘤缺乏典型的癥狀體徵,診斷睏難,提高對血管毬瘤的認識,運用Love試驗及高頻B超,可有效地避免誤、漏診.完整切除腫瘤可以穫得明確的療效.
목적 분석갑외혈관구류진단여치료적상관인소.방법 대2005년1월지2009년12월수술치료적22례갑외혈관구류진행회고성분석.22례중,남녀비례위1∶1.75(8∶14),년령위24～63세(평균39.4세),발병지수술시간위3개월지28년(평균84.8개월).혈관구류위우지복17례(점77.3%,17/22),지근절장측2례(점9.1%,2/22),수장2례(점9.1%,2/22),내과1례(점4.5%,1/22).기중다발류2례(점9.1%,2/22),외상사2례(점9.1%,2/22),가급종물9례(점40.9%,9/22),Love시험양성22례(점100%,22/22),랭민감시험양성7례(점31.8%,7/22).림상오진12례(점54.5%,12/22),B초발현솔22례(점100%,22/22).혈관구류평균직경위4.1 mm(2.0～7.0 mm).결과 22례술후수방시간위4～144개월,기중19례(점87.4%,19/22)술후전유,자발통급촉통소실.종류복발3례(점13.6%,3/22),재차술후미견복발.결론 갑외혈관구류결핍전형적증상체정,진단곤난,제고대혈관구류적인식,운용Love시험급고빈B초,가유효지피면오、루진.완정절제종류가이획득명학적료효.
Objective To analyze the related factors of the diagnosis and treatment of extraungual glomus tumors. Methods A retrospective analysis of 22 cases of extraungual glomus tumor treated from January 2005 to December 2009 were conducted. There were 8 male patients and 14 female patients with a malewas 84.8 months (range, 3 months to 28 years). The glomus tumors were located in the pulp in 17 cases (77.3%, 17/22), on the palmar side of the proximal finger in 2 cases (9.1%, 2/22), on the palm of the hand in2 cases (9.1%, 2/22), and at the medial malleolus in 1 case (4.5%, 1/22). There were 2 cases (9.1%,2/22) with multiple tumors, 2 cases (9.1%,2/22) with previous injury, and9 cases (40.9%,9/22)with palpable tumors. All ( 100% ,22/22) cases had positive Love test, while cold-intolerance test was positive in 7 cases (31.8% ,7/22). The clinical misdiagnosis rate was 54.5% (12/22). Ultrasonographic diagnosis was correct in all 22 cases ( 100%, 22/22). The average diameter of the tumor was 4.1 mm (range, 2.0 to 7.0mm). Results Postoperative follow-up period ranged from 4 months to 144 months. Cure was observed in 19 cases in which spontaneous pain and tenderness disappeared. Local recurrence occurred in 3 (13.6%)patients. No recurrence was observed after the second surgical excision. Conclusion Extraungual glomus tumors are difficult to diagnose due to the lack of specific symptoms and physical signs. A better understanding of the tumor, Love test and ultrasound examination are effective methods for reducing the rate of misdiagnosis.Complete excision of the tumor is an effective treatment method.
