原发性腹膜后肿瘤的诊断及治疗(附83例报告)

Diagnosis and treatment of primary retroperitoneal tumors—A report of 83 cases

目的 总结分析原发性腹膜后肿瘤的临床表现、诊断及治疗方法。方法 对 83例经手术切除病理证实的原发性腹膜后肿瘤患者的年龄、临床表现、病理类型、B型超声及CT检查的特点进行分析。结果 首发症状及体征多数为腹痛及腹部肿块。小儿良性腹膜后肿瘤以畸胎瘤多见 ;恶性以神经母细胞瘤多见。成人良性肿瘤以神经纤维瘤多见 ,恶性以脂肪肉瘤多见。B型超声及CT的诊断率分别为 71%及 77%。肿瘤手术切除率 6 5 .0 % ,其中良性为 89.2 % ,恶性为 45 .6 %。结论 对不明原因的腹痛患者应提高警惕 ,以利于对腹膜后肿瘤早期确诊。B型超声和CT是诊断原发性腹膜后肿瘤的重要手段 ,肿瘤与周围脏器及大血管的关系是影响手术切除率的主要因素。治疗应尽可能切除肿瘤 ,术后辅以化疗、放疗有助于改善生存质量和提高生存率。

Objective To discuss and analyze the clinical manifestations, diagnosis and treatment of primary retroperitoneal tumors. Methods Eighty three cases of primary retroperitoneal tumors were analysed in the age, clinical manifestations, pathological types, B ultrasonography, CT findings and operation resection rate. Results Abdominal pain and mass were the main symptoms and signs. Teratoma and neuroblastoma were the most popular types in children's benign and malignant primary retroperitoneal tumors respectively. Neurofibroma and liposarcoma were the common types in adults. The diagnostic rate by B ultrasonography and CT is 71% and 77% respectively. Total surgical resection rate was 65% ( 89.2% for benign and 45.6% for malignant). Conclusions To primary retroperitoneal tumors, more attention should be paid to abdominal pain patients. B ultrosonography and CT scan were the important methods for diagnosis of primary retroperitoneal tumors. The range and the relation of tumor to milieu organs and big vessels were the chiof factors influencing surgical resection rate. Total removal of tumors should be done if possible. Chemotherapy and radiation therapy were helpful to the survival rate and life quality.