摘要
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。
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 Ju- ly 2010, total 24 cases of intra-muscular hemangioma （IMH） was confirmed by post-operative patho- logical 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 9 year and 7 months）. The tumor tissue was completely resected in 22 cases, 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 ex- amination, 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 interven- tional therapy should be taken into account.
出处
《中华小儿外科杂志》
CSCD
北大核心
2012年第12期909-912,共4页
Chinese Journal of Pediatric Surgery
关键词
儿童
血管瘤
误诊
外科手术
Child
Hemangioma
Diagnostic errors
Surgical procedures, operative
