肝间叶性错构瘤诊断与治疗.docVIP

肝间叶性错构瘤诊断与治疗 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：肝间叶性错构瘤诊断与治疗 1 1 临床资料 2 2 结果 4 3 讨论 4 文2：小儿再发性腹痛诊断与治疗 8 1 RAP常见疾病诊治 9 2 RAP预后和预防 14 参考文摘引言： 14 原创性声明（模板） 15 文章致谢（模板） 15 正文 肝间叶性错构瘤诊断与治疗 文1：肝间叶性错构瘤诊断与治疗 Abstract： Objective To investigate the clinical features, diagnosis and treatment of mesenchymal hamartoma of the liver. Methods Two cases of children with mesenchymal hamartoma of the liver were analyzed retrospectively with literature It was difficult to diagnose the mesenchymal hamartoma of the liver preoperatively. Intraoperative frozen section diagnosis was helpful to differentiate the benign from the malignant, but final diagnosis depended only on postoperative pathological examination. Surgical excision of the tumor had a good prognosis, with occasionally local recurrence or Conclusion Mesenchymal hamartoma is a rare liver benign tumor in children, and may present with markedly increased serum alpha-fetoprotein (AFP). Imaging examination is of value in clinical diagnosis of this tumor; however familiarity with the radiologic findings of liver mesenchymal tumo and are needed, as well as the undetanding of their pathological backgrounds. Surgical operation is the best method now, and timely radical liver surgery (resection with a margin of normal liver parenchyma) should be recommended for mesenchymal hamartoma of the liver. Key words： liver neoplasm; mesenchymal hamartoma; operation 肝间叶性错构瘤（Mesenchymal hamartoma of the liver，MHL）为罕见的肝脏良性肿瘤，发病年龄通常为2周岁以内，亦有成人病例[ 1～2]。由于本病罕见，对其认识不够，临床容易误诊，现将我院2002年6月— 2006年12月收治的2例患儿临床资料结合国内外文献报道进行回顾性分析，以增强对MHL的认识、减少误诊、提高临床诊疗水平。 1 临床资料 2002年6月—2006年12月我院共收治2例MHL患儿，术前均未明确诊断，术后经病理确诊。 例1，男，年龄13个月。因腹部膨隆13个月，B超发现“腹膜后巨大混合性肿块”，以“腹膜后肿瘤”于2002年6月22日入院。查体：腹部高度膨隆，右上腹可触及一实性肿块，大小约15 cm×14 cm，质硬，边界尚清，活动度差，无压痛，脾肋下未触及。辅助检查：（1）腹部彩超：肝脏与右肾之间可见一大小为 cm× cm× cm 巨大肿块，包膜完整，形态不规则。肿块内回声强弱不均，内见 cm× cm 大小光斑样回声，其余为低弱回声。肝脏受压向上、向左移位，右肾向后侧方受压，余未见异常。 提示：腹膜后巨大混合性肿块，考虑来自右肾上腺区。（2）上腹部MRI所见：右侧腹腔巨大团块状软组织影，边界尚清，大小约 cm× cm× cm，其内信号欠均匀，呈混