体表巨大血管瘤的手术切除与整复治疗

Surgical resection of giant hemangioma

目的 通过 45例巨型血管瘤的手术治疗 ,阐明血管瘤选用手术切除是一种带有根治性的有效治疗方法。方法 ①术前放射数字减影 (DSA)检查 ,可明确诊断 ,了解病变范围 ,有利于手术设计等。②术中具体操作宜采用“假包膜剥离法”。③应用整复手术进行创面修复。结果 45例手术 ,一期治愈 2 7例 ,二期治愈 1 3例 ,治愈率达 89%。术后随访时间最长已达 8年 ,无复发 ,疗效好。结论 术前DSA检查结果是制定手术方案的重要依据。手术效果主要取决于术中能否沿着瘤体周围的“假包膜”完整剥离 ,实践证实 ,只有以“假包膜”为界完全剥离才能做到彻底切除瘤体 ,减少复发 ,达到根治目的 。

Objective\ Through the operative experiences in 45 cases of giant hemangioma, it is elucidated that the operative procedure for hemangioma is an effective, radical method of treatment Methods\ ① Preoperative DSA can establish the diagnosis, delineate the range of lesion and facilitate the design of operation. ② “Dissection over the false capsule' is applied in the operation. ③ The operative wound is repaired with a plastic procedure. Results\ Of the 45 patients primary cure was obtained in 27, and secondary cure in 13 with effective rate of 89 percent. The followed up was as long as 8 years with excellent results. Conclusions\ The establishment of operative scheme is chiefly based on preoperative DSA, and the success is fundamentally determined by complete dissection over the so called “false capsule' around the tumour during operation. This procedure can totally remove the tumour, eliminate recurrence and fulfil the purpose of radical resection, which is worthy of wide application.\;