小儿骶尾部畸胎瘤的临床研究  

Surgical treatment of sacrococcygeal teratoma in children

作　　者：苏泽礼[1] 柳琪[1] 吴佳龙[2] 刘冬[2] 于惊蛰 

机构地区：[1]宁夏医科大学总医院小儿外科,宁夏银川750004 [2]宁夏医科大学,宁夏银川750004

出　　处：《宁夏医学杂志》2014年第9期815-816,共2页Ningxia Medical Journal

摘　　要：目的探讨小儿骶尾部畸胎瘤的临床特点、手术方法及术后并发症的预防及处理。方法回顾性分析28例小儿骶尾部畸胎瘤的临床资料。结果 28例小儿骶尾部畸胎瘤患儿,I型(显型)14例(50.0%),II型(混合型)6例(21.4%),III型(哑铃型)4例(14.3%),IV型(隐型)4例(14.3%)。经骶尾入路手术22例,经腹骶尾联合人路手术5例。良性畸胎瘤21例(77.8%),恶性畸胎瘤6例(22.2%),其中1例为卵黄囊瘤,5例为胚胎性癌。获随访19例(良性16例,恶性3例),尚未发现复发与死亡病例,切口感染2例,慢性窦道1例。结论 AFP明显增高,结合CT、MRI检查对术前肿瘤良恶性判断有一定帮助,临床分型是选择手术入路的主要依据,术中严密缝合,术中、术后直肠内置入肛管等是减少术后并发症的重要措施。Objective To investigate the clinical characteristics,operation method and companied disease of sacrococcygeal ter- atoma in children. Methods The experience of clinic data of sacrococcygeal teratoma in 28 cases were retrospectively analyzed. Results Al128 children with sacrococcygeal teratoma （21 males and 7 females） were collected,who were classified into four types： 14 （50.0%） type I （phenotype） ,6 （21.4%） type II（hybrid） ,4 （ 14.3% ） type III（dumbbell） and 4 （ 14.3% ） type IV（concealed）. 22 cases were performed tumor resection through sacroeoccygeal approach and 5 case through abdominal and sacrococcygeal joint surgery. It included 21 cases of benign teratoma （77.8%） ,6 cases of malignant teratoma （22.2%） ,one case of yolk sac tumor and one case of embryonal carcinoma. After following- up of 19 cases （16 cases were benign,3 malignant）,no recurrence and death cases was found. There were two cases of incision infection and one case of chronic sinus. Conclusion AFP is significantly increased and combined with CT, MRI examination in preoperative tumor judgment has certain help. Clinical classification is the main basis for the selection of opera- tion approach. The patients are closely suturing, and intraoperative, postoperative rectal building into the anal canal, which is an important measure to reduce the postoperative complications.

关 键 词：骶尾部 畸胎瘤 手术方法 儿童 

分 类 号：R739.93[医药卫生—肿瘤]