论文部分内容阅读
1 病例报告例1:男,26岁.自幼于右侧胸背部发现海绵状肿物,随年龄逐渐增大,就诊前20天肿块溃破出血不止,经多次加压包扎血止.体检见右侧胸壁有一巨大质软肿块、上至腋窝,下至肋弓,前达胸骨缘,后及脊柱中线,大小为42cm×20cm×7cm.中央有明显血管瘤结节浸润皮肤,边缘分界不清.诊断右侧胸壁海绵状血管瘤,于1988年8月15日在全麻下手术.术中见血管瘤由大量扩张的血管窦组成并侵及肋间肌各肌层.沿血管瘤边缘正常肌肉组织向肿瘤中央基底游离,剥离受侵的肋间肌时大量出血,止血较困难,受侵的肋间肌作姑息性部分切除,在离体的肿瘤表面取中厚皮片,覆盖创面作一期植皮.因大量输血、输液术后出现急性肺水肿,对症处理后控制.术后1个月部分皮片坏死作二期植皮痊愈.随访5年,局部无复发.切除标本病理报告为海棉状血管瘤.
1 Case report Example 1: Male, 26 years old. Sponge-like masses were found on the right chest and back since childhood. Gradually increasing with age, 20 days before the diagnosis, the masses collapsed and bleeding ceased. After multiple pressure dressings, the blood was stopped. See the right chest wall with a large soft mass, up to the armpits, down to the rib arch, the front of the sternum border, posterior and midline of the spine, the size of 42cm × 20cm × 7cm. Central hemangiomas nodules infiltrated the skin, borderline demarcation is not Qing. Diagnosis of the right chest wall cavernous hemangioma, underwent general anesthesia on August 15, 1988. During surgery, the hemangioma consisted of a large number of dilated vascular sinuses and invaded the muscles of the intercostal muscles. Along the edge of the hemangiomas. The normal muscle tissue is released from the central basement of the tumor, and when the invaded intercostal muscles are detached, a large amount of hemorrhage occurs. It is difficult to stop the hemostasis. The infringed intercostal muscle is used as a palliative partial resection, and a thick skin graft is taken on the isolated tumor surface to cover the wound surface. For a period of skin grafting. Because of massive blood transfusions, acute pulmonary edema after infusion, symptomatic control after treatment. Skin necrosis was performed for two months after 1 month of skin graft healing. After 5 years of follow-up, there was no local recurrence. Resection specimens were reported as Spongiform hemangioma.