1例骶前囊肿报告  

A case report of presacral cyst

作　　者：赵玉鑫 史梦军 王志伟 李冬琳 孙莹月 姜川 管仲安[1] ZHAO Yuxin;SHI Mengjun;WANG Zhiwei;LI Donglin;SUN Yingyue;JIANG Chuan;GUAN Zhong’an

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250011

出　　处：《中医临床研究》2024年第36期68-70,共3页Clinical Journal Of Chinese Medicine

基　　金：齐鲁中医药优势专科集群项目-肛肠科(YWC2022ZHJQ0003)。

摘　　要：骶前囊肿是指发生于骶骨前、直肠后的囊性肿物,多见于中年女性,可根据组织胚胎学来源、病理性质的差异及肿瘤生长的性质等不同对其进行分类。由于本病病灶隐匿,疾病发展过程缓慢,早期无明显不适,发展到一定程度才会感受到隐痛、压迫、坠胀等不适,且容易继发感染,在临床上常被误诊为肛瘘或肛周脓肿。目前手术治疗仍是根治骶前囊肿的首选治疗方式,但由于囊肿位置较深,空间视野较为狭窄,操作比较困难,往往经过多次手术治疗后伤口难以愈合,治疗难度大,而若不能将囊肿根治,将严重影响患者的生活和生命质量。由于本病的解剖位置特殊,解剖关系较为复杂,临床须通过肛门指检、肛周及腔内彩超、盆底计算机断层扫描(CT)及盆底磁共振成像(MRI)等协助诊断。根据囊肿位置、性质及与周围组织浸润情况的不同,本病可选择经腹入路切除术、经阴道入路切除术、经骶旁入路切除术、经腹骶联合切除术和经腹会阴联合切除术等5种手术治疗途径。通过报告1例骶前囊肿的诊疗经过,从解剖、诊断依据、手术入路方式等方面进行相关讨论,旨在为临床该疾病的诊治提供借鉴。Presacral cyst refers to a cystic mass that occurs in the anterior sacrum and posterior rectum and it is common in middle-aged women.It can be classified based on its histological and embryological origin,differences in pathological properties,and the nature of tumor growth by using different methods.Due to the hidden lesions and slow progression of the disease,there is no obvious discomfort in the early stage,and discomfort such as dull pain,compression,bloating and distention will be felt when it develops to a certain extent,and it is prone to secondary infection,which is often misdiagnosed clinically as anal fistula or perianal abscess.At present,surgical treatment is still the preferred treatment for the radical treatment of presacral cyst.However,due to the deep location of the cyst,narrow spatial field of view,and difficult operation,the wound is often difficult to heal after multiple surgical treatment,and the treatment is difficult.If the cyst cannot be eradicated,it will seriously affect the life and quality of life of patients.Due to the special anatomical location and complex anatomical relationship of this disease,clinical diagnosis must be assisted by anal digital examination,perianal and intracavitary color ultrasound,pelvic floor CT and pelvic floor MRI,etc.,and according to the location,nature and infiltration of the cyst and surrounding tissue,there are five surgical treatment options for this disease:transabdominal approach resection,transvaginal approach resection,transsacral approach resection,transabdominal-sacral combined resection and transabdominal perineal combined resection.This article reports the diagnosis and treatment of a case of presacral cyst,and reviews and discusses related literature from the perspectives of anatomy,diagnosis basis,surgical approach,etc.,in order to provide reference for the clinical diagnosis and treatment of this disease.

关 键 词：骶前囊肿 手术治疗 病例报告 文献复习 

分 类 号：R323.46[医药卫生—人体解剖和组织胚胎学]