中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2012年
12期
909-912
,共4页
儿童%血管瘤%误诊%外科手术
兒童%血管瘤%誤診%外科手術
인동%혈관류%오진%외과수술
Child%Hemangioma%Diagnostic errors%Surgical procedures,operative
目的 探讨儿童肌间血管瘤的特点、分析误诊的原因、减少误诊的方法和手术治疗的关键点.方法 回顾性分析2001年7月至2010年7月经手术后病理检查证实的肌间血管瘤24例的治疗体会及误诊原因.结果 本组24例中有13例术前误诊,误诊率为54.2％.门诊获随访11个月～9年10个月,平均4年7个月.彻底切除的22例术后有1例复发；未完全切除术后2例复发,再次手术后没有再复发.随访时有5例轻微跛行或肌力下降,快步行走或奔跑时明显.无血管神经并发症.结论 儿童肌间血管瘤临床表现比较隐蔽,常规检查容易漏诊,应利用多种检查手段确诊,降低术前误诊率.术前明确病变范围,熟悉解剖位置,保护重要结构和肢体功能,争取彻底切除,如手术风险较大,应分次手术切除配合介入栓塞治疗.
目的 探討兒童肌間血管瘤的特點、分析誤診的原因、減少誤診的方法和手術治療的關鍵點.方法 迴顧性分析2001年7月至2010年7月經手術後病理檢查證實的肌間血管瘤24例的治療體會及誤診原因.結果 本組24例中有13例術前誤診,誤診率為54.2％.門診穫隨訪11箇月～9年10箇月,平均4年7箇月.徹底切除的22例術後有1例複髮；未完全切除術後2例複髮,再次手術後沒有再複髮.隨訪時有5例輕微跛行或肌力下降,快步行走或奔跑時明顯.無血管神經併髮癥.結論 兒童肌間血管瘤臨床錶現比較隱蔽,常規檢查容易漏診,應利用多種檢查手段確診,降低術前誤診率.術前明確病變範圍,熟悉解剖位置,保護重要結構和肢體功能,爭取徹底切除,如手術風險較大,應分次手術切除配閤介入栓塞治療.
목적 탐토인동기간혈관류적특점、분석오진적원인、감소오진적방법화수술치료적관건점.방법 회고성분석2001년7월지2010년7월경수술후병리검사증실적기간혈관류24례적치료체회급오진원인.결과 본조24례중유13례술전오진,오진솔위54.2％.문진획수방11개월～9년10개월,평균4년7개월.철저절제적22례술후유1례복발；미완전절제술후2례복발,재차수술후몰유재복발.수방시유5례경미파행혹기력하강,쾌보행주혹분포시명현.무혈관신경병발증.결론 인동기간혈관류림상표현비교은폐,상규검사용역루진,응이용다충검사수단학진,강저술전오진솔.술전명학병변범위,숙실해부위치,보호중요결구화지체공능,쟁취철저절제,여수술풍험교대,응분차수술절제배합개입전새치료.
Objective To explore the characteristics of intermascular hemangioma in children,potential cause of misdiagnosis,and key points in surgical therapy.Methods Between July 2001 to July 2010,total 24 cases of intra-muscular hemangioma (IMH) was confirmed by post-operative pathological examination in our department.Their clinical data and cause of misdiagnosis was retrospectively analyzed.Results 13 cases in them (54.2％) were confirmed to be misdiagnosed in pre-operation.Follow-up timeranged from 11 months to 9 year and 10 months (Average time follow-up time was 9year and 7 months).The tumor tissue was completely resected in 22 eases,and recurrence was found in 1 case.Also,2 cases undertaking incomplete excision recurred and no recurrence after secondary operation in them.During the follow-up period slight claudication and muscle weakness could be seen in 5 cases,especially when walking fast or running.The complications correlated to nerve and blood vessel was not found in them.Conclusions The signs of (IMH) is not easy to be found in physical examination,and multidisciplinary examination need to be performed to achieve accurate diagnosis.The scope and anatomy of lesion will contribute to complete resection of tumor tissue.Meanwhile,function of affected limbs need be maintained.In case of high risk,staging operation associated with interventional therapy should be taken into account.
