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目的研究胸部血管瘤的临床与病理学特点,提高临床诊断的准确性,减少并发症。方法回顾性分析2006年1月至2012年8月在四川大学华西医院接受手术治疗的胸部血管瘤患者9例,男2例,女7例;年龄47.9±19.3(18～71)岁。开胸手术6例,全胸腔镜手术1例,胸腔镜辅助小切口手术1例,由神经外科和胸外科分期完成手术1例。分析其影像学特点、术中肿瘤的大体特点和手术标本的病理学特点,比较不同手术方式治疗血管瘤的效果。结果本组手术治疗血管瘤患者9例,影像学上表现为类圆形占位占66.7%(6/9),分叶状占位占33.3%(3/9);磁共振成像(MRI)检查对术前诊断血管瘤具有一定的价值,特点是T2加权像瘤体增强。胸外科手术时间106.3±60.1(60～192)min,术中出血量91.1±43.7(30～150)ml。除1例患者随访1个月外,其余均随访3～6年,所有患者均无与本病相关的死亡发生,无复发和转移。结论胸部血管瘤大多为良性肿瘤,主要位于纵隔;结合血管瘤的大小、部位和医生的技术水平决定手术方式,胸腔镜手术对于血管瘤具有创伤小、出血少和住院时间短的优点;哑铃型血管瘤需要与神经外科医生协同完成。
Objective To study the clinical and pathological features of thorax hemangiomas, to improve the accuracy of clinical diagnosis and reduce the complications. Methods Nine patients with thoracic hemangiomas undergoing surgery in West China Hospital of Sichuan University from January 2006 to August 2012 were retrospectively analyzed. There were 2 males and 7 females, aged 47.9 ± 19.3 years (18-71 years). Thoracotomy in 6 cases, thoracoscopic surgery in 1 case, thoracoscopic assisted small incision in 1 case, completed by neurosurgery and thoracic surgery in 1 case. Analysis of its imaging features, intraoperative tumor characteristics and the general characteristics of the surgical specimens of the pathological features of different surgical methods for the treatment of hemangiomas effect. Results Nine patients with hemangiomas were surgically treated in this study. Imaging findings were round type with 66.7% (6/9) and 33.3% (3/9) with lobulation. MRI (magnetic resonance imaging) Check the preoperative diagnosis of hemangiomas has a certain value, characterized by T2 weighted tumor enhancement. Thoracic surgery time was 106.3 ± 60.1 (60 ~ 192) min, intraoperative blood loss 91.1 ± 43.7 (30 ~ 150) ml. All patients were followed up for 3 to 6 years except for one patient followed up for 1 month. All patients had no death related to this disease, no recurrence and metastasis. Conclusions Most of thoracic hemangiomas are benign and mainly located in the mediastinum. Combining the size, location of the hemangioma and the skill level of the doctor, the operation mode is decided. Thoracoscopic surgery has the advantages of less trauma, less bleeding and shorter hospital stay. The dumbbell type Hemangiomas need to be done in collaboration with neurosurgeons.