肝海绵状血管瘤77例的诊断与外科治疗

Diagnosis and surgical treatment of hepatic cavernous hemangioma 77 cases

目的：总结肝海绵状血管瘤的诊断与治疗经验。方法：回顾性分析1986年-2008年经手术证实的肝海绵状血管瘤77例临床资料。结果：肿瘤直径5～9cm42例，〉10cm24例，≤15cm11例。手术前确诊73例肝海绵状血管瘤，术前确诊率94．8％；4例误诊，误诊率5．2％，分别误诊原发性肝癌2例，巨大肝囊肿癌变1例，肝脏局灶结节性增生1例。3例腹腔出血、休克，急诊剖腹探查均死于术中；4例肿瘤巨大，经剖腹探查未能切除。70例均皆手术切除，手术切除率90．9％，肝叶切除术38例（4914％），剥除术21例（27．3％），局部切除术11例（14．3％）。70例无手术死亡，无严重并发症。结论：手术是治疗肝海绵状血管瘤最有效的手段；手术剥除术操作简单、创伤小、出血量少，便于推广应用。

Objective： To study diagnosis and treatment of hepatic cavernous hemangioma. Methods： Retrospective analysis 77 cases of cavernous hemangioma of liver confirmed by surgical operation from 1986 to 2008. Results： 42 cases of tumor diameter from 5 to 9 cm, greater than 10 cm 24 cases, less than or equal 15cm 11 cases, 73 cases diagnosed before surgery, preoperative diagnosis rate of 94.8%. 4 cases misdiagnosis, misdiagnosis rate of 5.2%, were misdiagnosed with primary liver cancer 2 cases, huge liver cyst cancer 1 case, hepatic focal nodular hyperplasia 1 case. 3 cases of intra-abdominal bleeding, shock, emergency laparotomy, died in surgery. 4 cases of large tumors failed to remove by laparotomy. 70 cases were surgical resection, resection rate of 90.9%, hepatectomy in 38 cases （49.4%）, cystectomy in 21 cases （27.3%）, partial resection in 11 cases （14.3%）. 70 cases no operative deaths, no serious complications. Conclusions- Operation is the most effective method of treatment for hepatic cavernous hemangioma. Cystectomy procedure is simple, less invasive, less blood loss and easy application.