手指复发血管球瘤手术治疗

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1、手指复发血管球瘤手术治疗【摘要】目的探讨并总结手指复发血管球瘤的诊断与治疗方法。方法手术治疗的复发手指血管球瘤13例，其中男2例，女11例，年龄17~38岁，其中食指4例，中指5例，环指和小指各2例。第一次手术后到再次手术的时间最短1月，最长5年，平均1．3年。13例患者中在术后有6例曾被误诊为甲沟炎、术后感染或伤口内异物。部分病例术前行彩色多普勒检查。13例患者均采用手术治疗。结果术后所有患者经病理学检查均诊断为血管球瘤。手术后疼痛三联征消失，伤口无一例感染患者，1例患者甲床小部分坏死，经换药后愈合，

2、指甲生长欠平滑4例，患者术后对于手指外观满意率85．6%。结论正确认识并诊断复发血管球瘤，并选择合理的手术入路，彻底切除肿瘤以减少复发，是取得良好治疗结果的关键。�【关键词】血管球瘤；手指；手术治疗SurgicaltreatmentoftherecrudescentglomustumorsofthefingersQIYong，LIGui-tao，WUGuang-qin，etal.DepartmentOrthopaedics，TheSecondHospitalofGuangdongProvince，Gua

3、ngzhou510317，China� 9【Abstract】ObjectiveTosummarizethediagnosisandsurgicaltreatmentoftherecrudescentglomustumorsofthefingers.Methods13caseswithrecrudescentglomustumorsofthefingerswereanalysedretrospectively.Amongthesecases，threepatientsweremale，and11were

4、female.Theagesarrangedfrom17to38yearsold.4casesoccurredinindexfinger，5inmiddlefingers，2inringfongersand2inlittlefingers.Themeanintervalperiodfromthefirstoperationtothesecondsurgeryisabout13months，theshortestwas1month，andthelongestwas5years.Amongthese13ca

5、ses，6patientshavebeenmisdiagnosedaspanaritium，postoperativeinfectionorcorpusalienum.SomepatientsacceptedcolorDopplerinordertoidentifythediagnoseandwhetherthereweretumorsinpalmsideofthefingers，especiallywhenpatientsfeelpainatthepalmofthefingers.Allthecase

6、sunderwentsurgicaltreatment.ResultsDuringtheoperationwefoundthat6caseshadtwoormoretumorbodies.Allthecasewereverifiedbypathology.Thetriadofpainweredisappearedinall9patientswithoutinfection.Butasmallareaofnailnecrosedinonecase，andhealedafterchangeofdressin

7、g.4nailsappearedunsmoothaftersurgery.About85．6%ofthecasesweresatisfiedabouttheresults.ConclusionThelocalrecrudescentglomustumorsofthefingersshoudbediagnoseddefinitelyandbetterunderstood.Iftheoperationwerepracticedthroughreasonableapproach，andtumorswerere

8、secttedthoroughly，aexcellentclinicalresultcanbegot.�【Keywords】Glomustumor;Finger;Surgicaltreatment血管球瘤(glomustumor9，GT)是一种较为少见的真性肿瘤，源自细小动静脉吻合处的血管球，多见于手指甲床下或甲床旁，在创伤等诱因下变异而来[1]。由于结缔组织包膜中有丰富的神经末稍，因此临床上手部血管球瘤具有典型的间歇性剧痛、难以忍受的触痛