论文部分内容阅读
患儿男性,3岁。1991年2月因发现上腹部包块,AFP 25400μg/L,MRI发现肝左叶巨大占位性病变而诊断肝母细胞瘤入院。2月21日在气管插管静脉复合麻醉下行左半肝切除术,肿瘤大小为10cm×10cm×12cm。病理诊断为肝母细胞瘤胚胎细胞型。术后恢复顺利。术后1个月AFP即降至30μg/L以下,出院后定期复查B超及AFP。1992年8月发现AFP升至1500μg/L,B超、CT均提示肝右后叶上段靠近下腔静脉处有一3cm×3cm占位性病变,于8月27日再次行剖腹探查。分离粘连后见右后叶上段有一3cm×3cm肿块,与膈肌粘连紧密,并紧靠肝右静脉下腔静脉入口处。分离肿瘤周围粘连,在未阻断肝门下行肿瘤局部切除,肝创面对拢缝合。术后患儿发生急性肺水肿,经抢救后脱
Children with children, 3 years old. February 1991 found that the upper abdominal mass, AFP 25400μg / L, MRI found a huge left liver lobe occupying lesions and the diagnosis of hepatoblastoma admission. February 21 in the endotracheal intubation anesthesia underwent left hepatectomy, the tumor size of 10cm × 10cm × 12cm. Pathological diagnosis of hepatoblastoma embryonal cell type. Postoperative recovery was successful. After 1 month AFP dropped to 30μg / L or less, after discharge regular review of B ultrasound and AFP. August 1992 AFP rose to 1500μg / L, B ultrasound, CT showed that the upper right posterior lobe of the liver near the inferior vena cava with a 3cm × 3cm mass lesions, again on August 27 laparotomy. Separation of adhesions see the right posterior lobe of a 3cm × 3cm mass, and diaphragm adhesion close, and close to the right hepatic vein IVC entrance. Isolation of tumor around the adhesions, did not block the local resection of the tumor downstream of the liver, liver wound closure suture. Postoperative acute pulmonary edema occurred in children, after rescue