肝脏海绵状血管瘤有关问题的探讨.DOCVIP

临床医学论文-肝脏海绵状血管瘤有关问题的探讨 【摘要】? 目的? 本文旨在探讨肝脏海绵状血管瘤(CHL)的某些相关问题, 以求提高该病的手术疗效。方法? 总结我院169例CHL的手术经验，探讨该病手术的有关问题(如诊断难度、手术指征、术式选择以及其他问题)。结果? 169例CHL均经手术与病理确诊。施行各种范围肝切除74例；CHL剥除术92例; CHL缝扎术1例；肝固有动脉结扎2例。本组术后除2例因严重并发症死亡(手术死亡率1.2%)外，167例均治愈。结论? （1）目前巨大CHL尚无公认的大小，所以我们期待在不久的将来能制定出国内统一的大小标准；（2）不典型的CHL诊断困难，尤其伴有AFP假阳性的CHL很难与HCC鉴别；（3）对CHL的手术适应证要灵活掌握，只要症状明显，CHL发展增大、快或不能除外肝恶性肿瘤者，不论CHL大小都应手术治疗；（4）术式中条件合适者应首选CHL剥除术，较小的CHL可用无水酒精注射或缝扎术；（5）有关手术的其他问题也予以探讨，并提出明确观点。 　　【关键词】? 肝脏海绵状血管瘤； 手术指征；术式选择??? 　　Investigation of some problems about cavernous hemangioma of the liver 　　【Abstract】? Objective? To investigate some problems pertaining to cavernous hemangioma of the liver(CHL),in order to heighten the therapeutic effect of CHL.Methods? We summarized the experience of CHL operation in 169 cases and inquire some problems.Results?All CHL cases were operated and diagnosed pathologically.Hepatectomy(various range)-74 cases,CHL enucleation-92 cases,suture and ligation of CHL- one case,proper hepatic artery ligation-2 cases.167 cases cured,2 cases died of severe complications postoperatively,operative mortality was 1.2%.Conclusion?We expect to make a unified criterion of giant CHL size of whole nation in the near future because there is no an accepted size at present.The diagnosis of an atypical CHL is very difficult,especially CHL presents a pseudopositive AFP result.The operative indication of CHL should be decided flexibly,provided the patient manifests obvious symptoms,CHL enlarged quickly or the malignancy cant be excluded,regardless of size of CHL,it ought to be resected.The enucleation of?CHL would be selected firstly if the patients conditions are suitable.The smaller CHL can be treated with suture-ligation or ethanol injection measures.Other problems concerning CHL operation were inquired too and express own clear viewpoint. 　　【Key words】? cavernous hemangioma of the liver；operative indication;selection of operative modes ??? 肝脏海绵状血管瘤是肝脏最常见的良性肿瘤。由于对此瘤认识上有不同，故在处理上不尽妥当。我们收集我院过去25年间经手术及病理证实，