手指复发血管球瘤手术治疗.docVIP

手指复发血管球瘤手术治疗【摘要】 目的 探讨并总结手指复发血管球瘤的诊断与治疗方法。方法 手术治疗的复发手指血管球瘤13例，其中男2例，女11例，年龄17~38岁，其中食指4例，中指5例，环指和小指各2例。第一次手术后到再次手术的时间最短1月，最长5年，平均1．3年。13例患者中在术后有6例曾被误诊为甲沟炎 、术后感染或伤口内异物。部分病例术前行彩色多普勒检查。13例患者均采用手术治疗。结果 术后所有患者经病理学检查均诊断为血管球瘤。手术后疼痛三联征消失，伤口无一例感染患者，1例患者甲床小部分坏死，经换药后愈合，指甲生长欠平滑4例，患者术后对于手指外观满意率85．6%。结论 正确认识并诊断复发血管球瘤，并选择合理的手术入路，彻底切除肿瘤以减少复发，是取得良好治疗结果的关键。? 【关键词】血管球瘤；手指；手术治疗 Surgical treatment of the recrudescent glomus tumors of the fingers QI Yong，LI Gui-tao，WU Guang-qin，et al.Department Orthopaedics， The Second Hospital of Guangdong Province， Guangzhou 510317，China ? 【Abstract】 Objective To summarize the diagnosis and surgical treatment of the recrudescent glomus tumors of the fingers.Methods 13 cases with recrudescent glomus tumors of the fingers were analysed retrospectively.Among these cases， three patients were male， and 11 were female.The ages arranged from 17 to 38 years old.4 cases occurred in index finger， 5 in middle fingers， 2 in ring fongers and 2 in little fingers.The mean interval period from the first operation to the second surgery is about 13 months， the shortest was 1 month， and the longest was 5 years.Among these 13 cases， 6 patients have been misdiagnosed as panaritium， postoperative infection or corpus alienum.Some patients accepted color Doppler in order to identify the diagnose and whether there were tumors in palm side of the fingers， especially when patients feel pain at the palm of the fingers.All the cases underwent surgical treatment.Results During the operation we found that 6 cases had two or more tumor bodies.All the case were verified by pathology.The triad of pain were disappeared in all patients without infection.But a small area of nail necrosed in one case， and healed after change of dressing.4 nails appeared unsmooth after surgery.About 85．6%of the cases were satisfied about the results.Conclusion The local recrudescent glomus tumors of the fingers shoud be diagnosed definitely and better understood.If the operation were practice