肌内血管瘤的诊断及手术治疗

目的]总结肌内血管瘤(IMH)的临床特点、诊断方法和手术治疗经验.方法]收集1995年1月至2010年6月行手术切除并经病理证实的58例IMH完整病例,总结分析临床特点和辅助检查的临床价值,描述手术方式,提出手术要点.结果]所有病例均行手术切除治疗,连带受侵犯的正常肌肉一并完整切除肿瘤,但有2例因肿瘤侵犯膝关节囊和整个股外侧肌,未能完整切除,但术后症状明显减轻,并且肿瘤未有进一步生长.随访33例,时间18个月至13年,平均5.5年.2例复发,因复发肿瘤发展缓慢,患者无症状,未行进一步治疗.无感染病例,无恶变病例.结论]IMH临床常以局部疼痛,或同时伴有肿物,或者仅以发现肿物为表现.疼痛往往在运动后加重.结合辅助检查可以确诊.怀疑恶性肿瘤时术前须行病理明确.手术切除是主要治疗方法,术后复发率低.

Diagnosis and surgical management of intramuscular hemangioma

Objective To analyze the clinical feature,diagnostic methods and surgical management of intramuscular hemangioma(IMH).Methods This retrospective study included 58 cases of IMH surgically treated with the definitive histological diagnosis from January 1995 to June 2010.The clinical feature and value of the auxiliary examinations were analyzed.The procedure of surgery was described and the main points were put forward.Results All the cases were treated surgically,and all the tumors were excised totally with some normal muscle involved except 2 cases involved with the knee or the vastus lateralis.33 of 58 cases were followed up for an average of five and half years.Only 2 cases had local recurrence,but the recurred tumors were developed so slowly that the patients were not asked to be treated further,and none were infectant or transformed malignantly.Conclusions Clinical manifestation of IMH is local pain or/and bump.With the auxiliary examination,especially MRI,IMH is easy to diagnose,but sometimes it is critical to confirmed by histological diagnosis when it is considered to be malignant.Surgical excision is the main treatment.Recurrence rate is small.