肢端血管球瘤的诊治分析  

CLINICAL ANALYSIS OF DIAGNOSIS AND TREATMENT OF ACRAL GLOMUS TUMOR

作　　者：魏代清[1] 项舟[1] 杨婧[1] 黄富国[1] 岑石强[1] 钟刚[1] 张世琼[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国修复重建外科杂志》2014年第4期499-502,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 总结肢端血管球瘤的特点及诊断、治疗方法,以提高临床诊疗水平。方法 回顾性分析2004年6月-2013年10月收治的70例肢端血管球瘤患者临床资料。男11例,女59例;年龄18～67岁,平均41岁。病程4个月～30年,中位病程5年。单发病灶69例,多发病灶1例。病灶位于手指66例（67指）,足趾4例（4趾）;其中位于甲下44例（44指、1趾）。患者均有阵发性疼痛、局部触痛,Love’s试验均呈阳性;冷敏感试验阳性29例（28指、1趾）。术前高频彩色多普勒超声检查提示52例（48指、4趾）符合血管球瘤表现。X线片检查示16例（14指、2趾）可见指（趾）骨被肿瘤长期压迫或侵及形成的凹陷。结果 术后患者切口均Ⅰ期愈合,无延迟愈合及感染。70例均获随访,随访时间1个月～9年2个月,中位时间20个月。术后患指（趾）疼痛症状均消失,无活动、功能障碍。随访期间无复发。结论 肢端血管球瘤具有典型临床表现,结合高频彩色多普勒超声进行术前定性及精确定位,有助于制定手术方式并完整切除肿瘤,预后较好。Objective To summarize the characteristics, diagnosis, and treatment of acral glomus tumor in order to improve the level of diagnosis and treatment. Methods The clinical data from 70 cases of acral glomus tumor treated between June 2004 and October 2013 were analyzed retrospectively. There were 11 males and 59 females with an average age of 41 years （range, 18-67 ）＇ears）. The disease duration ranged from 4 months to 30 years, with a median duration of 5 years. Sixty- nine cases had solitary tumors and only 1 patient had more than 1 lesion. The tumors were located on the finger in 66 patients （67 fingers） and the toe in 4 patients （4 toes）; among them, the subungual glomus tumor happened in 44 patients （44 fingers and 1 toe）. All patients suffered from paroxysmal pain and pinpoint pain with positive Love＇s pin test, and 29 patients （28 fingers and 1 toe） had positive cold sensitivity. Fifty-two patients （48 fingers and 4 toes） were found to have glomus tumor according to the high-frequency color doppler ultrasonography. X-ray films revealed depression on the phalanx in 16 patients （14 fingers and 2 toes）. Results No patient suffered from delayed incision healing, and infection after surgical treatment. The follow-up time was from I month to 9 years and 2 months with a median follow-up time of 20 months. The clinical symptoms disappeared after surgery with no dysfunction or recurrence. Conclusion The diagnosis of acral glomus tumor is easy because of the typical symptoms： paroxysmal pain, pinpoint pain, and cold sensitivity. High-frequency color doppler ultrasonography may play an important role in the preoperative assessment of glomus tumors with accurate localization.

关 键 词：肢端血管球瘤 高频彩色多普勒超声 诊断 治疗 

分 类 号：R739.96[医药卫生—肿瘤]