腹膜后神经鞘瘤29例诊治研究  

Diagnosis and trerapy of retroperitoneal schwannoma in 29 cases

作　　者：宣然 曹先东[1] XUAN Ran;CAO Xiandong(General Surgery Department of The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]安徽医科大学第一附属医院普外科,安徽合肥230022

出　　处：《安徽医药》2018年第7期1339-1342,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨腹膜后神经鞘瘤的诊断、治疗及预后。方法回顾性分析29例腹膜后神经鞘瘤患者的临床资料,并进行总结。结果腹膜后神经鞘瘤临床表现多样,可表现为腹痛腹泻、恶心呕吐、腰背部疼痛等。术前影像学诊断为神经源性肿瘤21例(72.4%),其他来源肿瘤8例(27.6%)。29例患者均行手术治疗,腹腔镜手术时间为(128.91±20.40)min,开腹手术时间为(161.17±38.47)min,两者比较差异无统计学意义(P=0.097)。腹腔镜手术患者术后住院日为(6.00±0.63)d,开腹手术患者术后住院日为(11.17±6.00)d,两者比较差异有统计学意义(P=0.047)。良性随访均未见复发,恶性中1例复发行二次手术。结论腹膜后神经鞘瘤临床表现多样,术前不易诊断,影像学检查对其术前诊断具有较大价值,手术切除为最有效治疗方法。腹腔镜手术术后住院时间短,适用于瘤体较小的患者。Objective To investigate the diagnosis,treatment and prognosis of retroperitoneal schwannoma. Methods Clinical data of 29 patients with retroperitoneal schwannoma were retrospectively analyzed and summarized. Results The clinical manifestations of retroperitoneal schwannoma are varied,which can be characterized by abdominal pain,nausea and vomiting and lower back pain,etc.The imaging diagnosis was 21 cases（ 72. 4%） of neurogenic tumors,and 8 cases（ 27. 6%） of other tumors. All 29 patients underwent surgical treatment,and the time of laparoscopic surgery was（ 128. 91 ± 20. 40） min The operation time was（ 161. 17 ± 38. 47） min,with no statistically significant difference（ P = 0. 097）. After laparoscopic surgery,postoperative hospital stay（ 6. 00 ± 0. 63） d,and postoperative hospital stay day（ 11. 17 ± 6. 00） d,the difference was statistically significant（ P = 0. 047）. None of the benign followup was seen,and one of the malignant patients underwent secondary operation. Conclusions The clinical manifestation of retroperitoneal schwannoma is varied and preoperative diagnosis is not easy to diagnose. Imaging examination has great value in preoperative diagnosis. Surgical excision is the most effective treatment method. The length of hospitalization of laparoscopic surgery was short which applicable to patients with smaller tumors.

关 键 词：神经鞘瘤 腹膜后间隙 体层摄影术 螺旋计算机 超声检查 消化系统外科手术 

分 类 号：R735.4[医药卫生—肿瘤]