论文部分内容阅读
目的总结新生儿骶尾部畸胎瘤的诊断及治疗要点。方法回顾性分析2000年1月-2008年12月本院收治的57例新生儿骶尾部畸胎瘤的临床表现、辅助检查、手术、病理,及术后并发症的预防等资料。结果57例中男23例,女34例;年龄3～28d。显型41例,隐型3例,混合型13例。均行手术完整切除肿瘤,并切除尾骨,修复盆底结构。术后并切口感染11例,直肠损伤并肠瘘2例,均经综合治疗痊愈。病理检查发现4例为恶性,占7%;53例为良性,占93%。随访3个月～5a,复发7例,占12.28%,5例查甲胎蛋白(AFP)>250ng/L,考虑恶性复发,未行二次手术及化疗,均死亡;2例AFP<250ng/L,行二次手术治愈。结论新生儿骶尾部畸胎瘤以良性居多,手术完整切除瘤体,并切除尾骨是减少肿瘤复发及恶变的关键;术中盆底结构的良好修复可防止术后大便失禁及直肠脱垂;术后俯卧位及创面置管负压吸引等措施可减少切口感染。
Objective To summarize the diagnosis and treatment of neonatal sacrococcygeal teratoma. Methods A retrospective analysis of 57 cases of sacrococcygeal teratoma admitted to our hospital from January 2000 to December 2008 was performed. The clinical manifestations, auxiliary examinations, surgery, pathology and prevention of postoperative complications were retrospectively analyzed. Results 57 cases of 23 males and 34 females; aged 3 ~ 28d. 41 cases were phenotype, 3 cases were hidden and 13 cases were mixed. All patients undergone complete resection of the tumor, and removal of the coccyx, pelvic floor repair structure. Postoperative incision infection in 11 cases, rectal injury and intestinal fistula in 2 cases, were cured by comprehensive treatment. Pathological examination found that 4 cases were malignant, accounting for 7%; 53 cases were benign, accounting for 93%. Followed up for 3 months to 5 years, 7 cases (12.28%) were relapsed, 5 cases were diagnosed with AFP> 250 ng / L, 2 cases died of malignant recurrence, 2 cases of AFP <250 ng / L, line two surgical cure. Conclusions Neonatal sacrococcygeal teratoma is benign, the complete removal of the tumor by surgery and the removal of the coccyx are the key to reduce tumor recurrence and malignant transformation. Intraoperative pelvic floor structure is well repaired to prevent postoperative fecal incontinence and rectal prolapse Posterior prone and wound suction suction and other measures to reduce incision infection.