甲板分区法在甲下血管球瘤手术中的应用

Application of nail division method in surgery of subungual glomus tumor

目的利用甲板分区法指导甲下血管球瘤的术式选择,观察手术疗效,分析诊治要点。方法回顾性分析并随访积水潭医院手外科自2019年1月至2020年4月收治的37例甲下血管球瘤患者,单指发病35例,双指发病2例,根据自创甲板分区法选择不同术式,其中28指行甲板开窗甲床切开人路,11指行甲沟旁切开人路,采用视觉模拟评分(visual analogue scale,VAS)评价术后疼痛症状缓解情况,同时观察肿瘤复发情况。结果本组患者术后随访时间为12~27个月,平均21个月,末次随访时VAS为(0.3±0.8)分,有2指出现复发,其中1指为原位复发,1指为原病灶旁复发。结论手术治疗甲下血管球瘤效果显著,但术后有复发可能,利用甲板分区法可以指导手术方式的选择。

IObjectiveTo guide the selection of surgical procedures for subungual glomus tumors using the nail division method,observe the efficacy of surgery,and analyze the main points of diagnosis and treatment.Methods A retrospective analysis and follow-up were made on 37 patients with subungual glomus tumors treated by the department of hand surgery of Jishuitan Hospital from January 2019 to April 2020.Among them,35 cases were diagnosed with single finger disease and 2 cases were diagnosed with double fingers disease.Different surgical procedures were selected according to original nail division method,including 28 fingers with nail fenestration and nail bed incision approach,11 fingers with paranail incision approach.The visual analogue scale(VAS)was used to evaluate the relief of postoperative pain symptoms.At the same time,tumor recurrence was observed.Results The patients in this group were follow-up for 12 to 27 months,with an average of 21 months.At the last follow-up,the VAS was(0.3±0.8)points.There were 2 recurrences,including 1 in situ recurrence and 1 near the original focus recurrence.ConclusionThe surgical treatment of subungual glomus tumors is effective,but it may recur after operation.The nail division method can guide the choice of surgical procedures.