原发性腹膜后肿瘤9例诊治研究.docVIP

原发性腹膜后肿瘤9例诊治研究【摘要】 目的 探讨原发性腹膜后肿瘤的诊治及治疗。方法 回顾2006年至2009年经手术和病理证实的原发性腹膜后肿瘤9例，分析其年龄、临床表现、辅助检查、病理类型及外科治疗等治疗等临床资料。结果 首发症状及体征多数为腹部包块及腹痛。6例手术顺利切除肿瘤，2例术中探查行组织活检，1例围手术期死亡。结论 本病早期缺乏典型症状，彩超、CT等影像学检查是本病诊断的重要手段。完整切除肿瘤是治疗的关键和影响预后的重要因素。对侵犯脏器者采用累及脏器一并切除，不能切除和切除后再发的主张探查活组织检查和再次手术切除。 【关键词】 原发性腹膜后肿瘤；诊断；治疗 9 Cases of Primary Retroperitoneal Tumors Diagnosis Analysis. CHENG Zhang-lin，WANG Guo-feng，LI Yan-hong.The first people?s hospital of xinyang，xinyang464000，China 【Abstract】 Objective To investigate the diagnosis and treatment of primary retroperitoneal tumors and treatment. Methods A retrospective review of 2006 to 2009 by surgery and pathology of primary retroperitoneal tumors were done in 9 cases,analyzed its age, clinical manifestation, auxiliary examination and pathologic types and surgical treatment data. Results Starting symptoms and signs were almost abdominal bag piece and abdominal pain. Six patients were operated smoothly tumor resection, 2 cases took intraoperative biopsy probe line, 1 case died during perioperative period. Conclusion Msa early lacks the typical symptom, color dopplar ultrasound, CT imaging diagnosis of this disease is such as the important means. Complete resection is the key and treatment of important factors affect prognosis. For the infringement of viscera apply involving the viscera remoed, unresectable and excision again hair claims exploration biopsy and again removed surgically. 【Key words】 Primary retroperitoneal tumors； Diagnosis；Treatment 原发性腹膜后肿瘤(primary retroperitoneal tumor,PRT)是指起源于腹膜后间隙的肿瘤，组织来源包括脂肪、疏松结缔组织、筋膜、肌肉、血管、神经、淋巴组织和胚胎残留组织，但一般不包括胰腺、肾、肾上腺等实质性脏器肿瘤和腹膜后血管瘤。PRT发病率低仅占全身肿瘤的0.07%～0.20％［1］。由于其位置隐蔽，早期大多数无特殊的临床症状而不易被发现，患者就诊时多因病变广泛常常致手术无法彻底切除肿瘤，治疗上较为困难。我院从2006年1月至2009年12月，共收治原发性腹膜后肿瘤患者7例。现诊治情况分析如下。 1 临床资料 1.1 一般资料 本组病例9例，其中男5例，女4例，男女比例为1.3?∶?1.0。年龄52岁～73岁，平均58岁。首发症状：腹部包块5例，腹痛、腹胀2例，邻近脏器压迫症状1例，体检时彩超发现1例。9例均行手术治疗。术前行彩超检查，阳性率7例(77.7%)术前行螺旋CT平扫加增强检查，阳性率100%，并可明确肿瘤与腹膜后血管的关系。 1.2 手术情况 本组9例单纯瘤体切除4例，瘤体长径分别为8 cm，20 cm。联合小肠切除1例，联