CAJ | 학술논문

目的寻找盆腔腹膜后肿瘤的诊断依据,总结治疗方法.方法对象为于2000年10月至2011年10月因盆腔肿物就诊于北京大学人民医院的16例腹膜后肿瘤患者,总结一般临床资料、既往史、查体、辅助检查、术中所见、术后病理及术后随访等情况.结果 2例患者通过MRI术前诊断腹膜后肿瘤,其余均术中发现.除1例因高龄,肿物糟脆行肿物大部分切除术外,其余均行肿物完整切除.术后病理良性病变10例,盆腔子宫内膜异位症(非典型增生)1例；恶性肿瘤患者5例.16例手术时间1.45～8.5 h,术中出血量50～ 5000 ml,12例盆腔存在较重粘连,7例术中请相关科室同台协作完成,1例术中发生髂外静脉损伤和膀胱破裂.16例中失访1例,12例恢复良好,2例因疾病复发死亡,1例术后4个月复发,目前化疗中.结论腹膜后肿瘤手术治疗是关键,其术前诊断率低,往往术中意外发现,手术困难,并发症多,必要时需多科室共同完成.术前正确诊断、充分的术前准备对治疗尤为重要,辅助检查中MRI不失为一种有效的手段.
목적 심조분강복막후종류적진단의거,총결치료방법.방법 대상위우2000년10월지2011년10월인분강종물취진우북경대학인민의원적16례복막후종류환자,총결일반림상자료、기왕사、사체、보조검사、술중소견、술후병리급술후수방등정황.결과 2례환자통과MRI술전진단복막후종류,기여균술중발현.제1례인고령,종물조취행종물대부분절제술외,기여균행종물완정절제.술후병리량성병변10례,분강자궁내막이위증(비전형증생)1례；악성종류환자5례.16례수술시간1.45～8.5 h,술중출혈량50～ 5000 ml,12례분강존재교중점련,7례술중청상관과실동태협작완성,1례술중발생가외정맥손상화방광파렬.16례중실방1례,12례회복량호,2례인질병복발사망,1례술후4개월복발,목전화료중.결론 복막후종류수술치료시관건,기술전진단솔저,왕왕술중의외발현,수술곤난,병발증다,필요시수다과실공동완성.술전정학진단、충분적술전준비대치료우위중요,보조검사중MRI불실위일충유효적수단.
Objective To explore the diagnostic rationales for pelvic retroperitoneal tumors and summarize their therapeutic regimens.Methods A total of 16 retroperitoneal tumor patients were recruited.And their general information,previous medical history,physical examinations,auxiliary tests,surgical findings and postoperative pathological results were analyzed.Results Two cases were diagnosed through preoperative magnetic resonance imaging (MRI) while others found intraoperatively.Complete tumor resection was performed in all except for one case.Postoperative pathological examinations revealed 10 benign cases.And there was one case of pelvic endometriosis (mild cytologic atypia).Five cases were malignant.The operation duration was 1.45-8.5 hours and peri-operative bleeding volume 50-5000 ml.Among them,12 patients had heavy adhesion in pelvic cavity,7 cases underwent operations collaboratively with related departments because of surgical difficulties and vascular injury and bladder rupture occurred in 1 case.During the follow-ups,one case was lost,two patients died from disease recurrence and another one had a postoperative relapse at Month 4.The other 12 cases recovered well and had no recurrence.Conclusion Surgery remains a key for retroperitoneal tumors.With a low diagnostic rate,they are often found surprisingly intraoperatively.Because of surgical difficulties and frequent complications,multidepartmental collaboration is necessary.Preoperative correct diagnosis and adequate preoperative preparation are essential.And MRI is an effective auxiliary examination.