经甲床缘切口治疗手指末节血管球瘤

Resection of distal digit giomus tumor through a periungual incision

目的探讨应用甲床缘切口治疗手指末节血管球瘤的可行性及临床效果。方法2005年6月至2010年7月，对14例手指末节血管球瘤患者，通过甲床缘切口形成携带骨膜的甲床瓣或指腹瓣，充分游离达到甲下或指腹区域，在显微镜视下仔细分离后完整地切除血管球瘤。结果术后患者切口均l期愈合，病理检查证实为血管球瘤。术后随访12～55个月，平均26．7个月。14例患者疼痛症状完全消失，甲床愈合良好，指甲生长正常、外观良好，无并发症发生，随访期间无一例复发。结论应用甲床缘切口联合显微外科技术治疗手指末节血管球瘤，操作简单、切口隐蔽、创伤小、并发症少，肿瘤切除彻底，术后复发率低。

Objective To discuss the feasibility and clinical effects of the treatment of distal digit glomus tumors through a periungual incision. Methods From June 2005 to July 2010, 14 cases of distal digit glomus tumor underwent surgical excision using a periungual incision. A nail bed or nail pulp flap was elevated to include the periosteum to gain full access to the subungual or finger pulp region under the microscope. The glomus tumor was completely removed by microsurgical resection and subjected to pathological examination. Results Postoperatively all wounds healed primarily. Pathology confirmed the diagnosis of glomus tumor in all the patients. All cases were follow-up from 12 to 55 months with an average of 26.7 months. By the end of the follow-up, all patients had complete postoperative relief of pain. The nails recovered completely with normal shape. No complications and recurrences were observed. Conclusion The microsurgical treatment of distal digit glomus tumors via a periungual approach is an effective new method. This approach is easier, less traumatic and causes fewer complications than the conventional method. The tumor can also be completely resected, which can decrease the recurrence rate.