肌间血管瘤的手术治疗与误诊分析

目的探讨肌间血管瘤手术治疗的关键点及误诊的原因，更好地提高肌间血管瘤的诊治水平。方法用回顾性的方法，对1999年1月～2008年12月收治的34例肌间血管瘤病人的误诊情况、手术治疗结果进行分析总结。结果34例病人均进行了手术治疗，31例完全切除者术后均无复发，不完全性切除3例。有2例前臂的肌间血管瘤，术后伸指功能受到不同程度的影响，其中1例是前臂伸肌群切除太多，另1例是桡神经从瘤体中游离后，影响其对肌肉的支配。34例患者中有12例误诊，误诊率达到35％以上。结论肌间血管瘤手术治疗的关键点是首先必须确诊，其次是确保手术中能够有效控制出血，力争完全切除瘤体．注意重要结构及肢体功能的保护。肌间血管瘤易误诊原因是多方面的，但医生高度重视并恰当选用彩色多普勒、MRI等检查可避免误诊。

Surgical Operation for Intramuscular Hemangioma and the Reason Analysis of Its Misdiagnosis

Objective To study the key point of intramuscular hemangioma （IMH） operation and its misdiagnosis reasons in order to improve the treatment and diagnosis level of intramuscular hemangioma. Methods To analyze and summarize the misdiagnosis information and operation results of 34 cases diagnosed intramuscular hemangioma treated from January 1999 to December 2008 with retrospective study. Results 34 cases were carried out with surgical operation, of which 31 cases were resected fully and no recurrence were found, 3 cases were re- sected incompletely. The function extend fingers were affected partly in 2 cases, one because of forearm extensor muscles moved greatly, the other due to radial nerve dissociation from its controlled muscles. 12 cases were diagnosed, with the ratio ofmisdiagnosis of 35%. Conclusion Making a definite diagnosis before operation, effective control of hemorrhage, completely resection limb function protection in operation were the key points of intramuscular hemangioma, The misdiagnosis causes of the disease were various, but the doctor＇s alertness of the disease, col- or Doppler and MRI examination for suspected cases can avoid misdiagnosis completely.