原发性腹膜后肿瘤外科治疗分析.DOCVIP

临床医学论文-原发性腹膜后肿瘤外科治疗分析 【摘要】? 目的? 探讨腹膜后肿瘤的诊断与治疗方法。方法? 回顾总结50例原发性腹膜后肿瘤诊断治疗情况。结果? 本组50例原发性腹膜后肿瘤，CT诊断腹膜后肿瘤准确率达85%以上，B超诊断准确率为50%左右。手术是治疗腹膜后肿瘤最有效的办法，本组良性肿瘤切除率为87%，恶性肿瘤切除率为51%。结论? 腹膜后肿瘤CT检查具有重要价值，应作为首选。对已确诊或未确诊均应尽早手术，对不能切除的肿瘤，应力争做部分切除。对复发的病人，应积极争取再次手术。根据病理类型，采用相应的放疗或化疗，以延长病人的生存时间，降低复发率。 ??? 【关键词】? 腹膜后肿瘤;诊断;治疗 ???? Diagnosis and treatment analysis of 50 cases of primary retroperitoneal tumor ??? 【Abstract】? Objective? To evaluate the diagnosis and treatment of PRT.Methods? It is reviewed summarized the conditions of 50 PRT cases under diagnosis and treatment.Results?In this group of 50 PRT cases,the accuracy rate of CT diagnosis PRT is above 88%,and that of BUS is about 50%.Operation is the most effective way to treat PRT.In this group,the resect rate of benign tumor is 86% and that of malignant tumor is 36% and the total resect rate is 51%.Conclusion?The CT diagnosis for PRT is of great value and be first on the list of examination means for PRT.And either certainly diagnosed or uncertainly diagnosed cases should be operated as soon as possible.In the tumor which cannot be cut off to be excised partly and for the cases of recurrence to be operated for a second time.After operation adoption the correspondence with radiate cures or chemical cures according to the pathological type so as to extend the patients life and to reduce the recurrence rate. ??? 【Key words】? retroperitoneal neoplasms;diagnosis;treatment ??? 原发性腹膜后肿瘤比较少见，国内报道约数百例。我院1980～2004年间共收治经手术证实的50例，现报告如下。 ??? 1? 临床资料 ??? 1.1? 一般资料? 本组50例，男20例,女30例；年龄最小8个月，最大68岁;病程2年以上7例，1～2年以上10例，6个月～1年18例，6个月以内15例。其中属肿瘤复发3例。主要临床表现：腹痛伴有腹部肿块40例，仅有包块而无任何临床症状者10例，伴有双下肢疼痛3例，上消化道出血1例，发热3例，贫血9例，不完全性肠梗阻2例。 ??? 1.2? 诊断? 术前确诊为腹膜后肿瘤36例（72%），诊断为脾肿瘤2例，胃癌并出血1例，胆囊炎1例，胆囊癌1例，卵巢肿瘤4例，回盲部肿瘤1例，直肠癌1例，肝肿瘤2例，肠系膜囊肿1例。 ??? 1.3? 术前检查? CT检查30例，确诊为腹膜后肿瘤27例，符合率为90%，提示肝癌1例，肾肿瘤1例，回盲部肿瘤1例，直肠肿瘤1例。B超(BUS)检查32例，提示腹膜后肿瘤16例，符合率为50%，提示脾肿瘤2例，卵巢肿瘤4例，肝肿瘤2例，仅提示腹腔肿块8例。钡灌肠8例，提示直肠癌1例，提示肠道外肿瘤4例，未发现异常3例。上消化道钡餐11例，提示胃底外压性肿块4例，胃肠道肿瘤3例，未发现异常4例。肾分泌造影8例，均未发现异常。 ??? 1.4? 治疗方法? 5