结直肠海绵状血管瘤的诊断及外科治疗

Diagnosis and surgical treatment of colorectal cavernous hemangioma： a report of 4 cases and review of Chinese literatures

目的总结国内文献中结直肠海绵状血管瘤的临床病例特点和外科治疗方式。方法回顾性分析北京协和医院1993年至2006年收治的4例和检索1979年至2006年国内文献报道的54例结直肠海绵状血管瘤的病例资料。结果男女发病比例为1．0：1．0，43．1％的患者在婴幼儿时期发病，98．3％的患者表现为反复血便，纤维结肠镜、直肠CT和磁共振成像的诊断准确率为100％。91．4％的患者病变呈弥漫浸润性，8．6％的病变表现为局限性。82．8％的患者接受了外科干预治疗，3．5％的患者未接受治疗。结论纤维结肠镜是诊断结直肠海绵状血管瘤的首选诊断方式。外科手术方式的选择方面应该根据患者的具体情况而定。

Objective To summarize the clinical features and surgical methods for colorectal cavernous hemangioma in China. Methods Data of 4 cases in Peking Union Medical College Hospital and 54 cases with colorectal cavernous hemangioma from 1979 to 2006 reported in Chinese literatures were analyzed retrospectively, including clinic manifestations and surgery treatment. Results The incidence of male to female was 1.0：1.0, and 43.1% of the patients had their first onset of recurrent rectal bleeding in early childhood. Colonoscopy, rectal CT scan and MRI were the accurate methods for the diagnosis （100%）. 91.4% of the patients had diffuse infiltrative lesions and 8.6% of the patients had localized lesions. 82.8% of the patients underwent surgical treatment while 3.5% of the patient did not received treatment. Conclusions Colonoscopy is the first choice for the diagnosis of colorectal cavernous hemangioma. Local resection should be performed for the localized cavernous hemangioma. Sigmoid colon and rectum resection with coloanal anastomosis is suitable for the diffuse and infiltrative colorectal cavernous hemangioma.