新生儿腹部实体肿瘤  

Abdominal solid tumors in neonates

作　　者：李穗生[1] 刘唐彬[1] 苏诚[1] 李桂生[1] 

机构地区：[1]中山大学附属第一医院小儿外科,广州510080

出　　处：《中华小儿外科杂志》2005年第9期461-463,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的通过总结我院收治的25例新生儿腹部实体肿瘤的临床资料,探讨新生儿腹部实体肿瘤的诊治经验.方法回顾分析1980年1月～2003年12月治疗25例新生儿腹部实体肿瘤,男15例,女10例,年龄从出生后3～30 d,出生前经B超诊断胎儿腹部占位性病变9例,占36.0%,恶性实体瘤13例,占52.0%.肝母细胞瘤7例,肝错构瘤2例,神经母细胞瘤5例,先天性中胚层肾瘤2例,腹膜后良性畸胎瘤4例,胃恶性畸胎瘤1例,卵巢囊肿2例,肾上腺错构瘤1例,肾上腺腺瘤1例.肿瘤完整切除20例,肿瘤部分切除1例,仅行肿瘤活检4例.结果肝母细胞瘤存活2例,死于化疗毒副反应1例,失访4例,肝错构瘤生存2例,神经母细胞瘤生存4例,死于化疗毒副反应1例.除1例胃恶性畸胎瘤术后失访外,其余病例均长期生存.结论新生儿腹部实体肿瘤罕见,但通过产前B超可早期发现,出生后小儿外科医师应早期介入,根据病种采取合理检查及治疗手段,包括早期手术,术后合理、规范的化疗,可提高患儿的救治率.Objective To sum up the experience of diagnosis and treatment of abdominal solid tumors in neonates. Methods Twenty five neonates （male 15 and females 10, aged from 3 to 30 days） with abdominal solid tumors were treated in this institution between January of 1980 and December of 2003. Nine patients （36%） were diagnosed as abdominal mass lesions through prenatal ultrasonography. Diagnoses included hepatoblastoma （n = 7）, hepatic hamartoma （n = 2）, neuroblastoma （n = 5）, congenital mesoblastic nephroma （n = 2）, retropertoneal benign teratoma （ n = 4）, gastric malignant teratoma （n = 1）, ovarian cyst （n = 2）, adrenal hamartoma （ n = 1 ）, adrenal adenomatosis （n = 1 ）. The tumors were completely resected in 20 cases, partly removed in 1 case, and the other 4 cases only underwent biopsy. Results Of 7 patients with hepatoblastoma, 2 keep alive, I died of chemotherapy toxicity, and the other 4 lost to follow-up. Two patients with hepatic hamartoma keep alive. Of 5 patients with neuroblastoma, 4 keep alive, 1 died of chemotherapy toxicity. The patient with gastric malignant teratoma lost to follow-up. Other patients are known of long-term survivor. Conclusions Neonatal abdiominal solid tumors can be founded through prenatal ultrasongraphy. The strategy of early operation, regular and suitable chemotherapy after operation can increase the survival rate.

关 键 词：肿瘤 新生儿 腹部占位性病变 实体肿瘤 化疗毒副反应 神经母细胞瘤 肝母细胞瘤 恶性畸胎瘤 肾上腺错构瘤 肿瘤部分切除 

分 类 号：R730.4[医药卫生—肿瘤]