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目的总结新生儿骶尾部畸胎瘤诊断及治疗要点。方法回顾性分析2000年1月～2010年1月本院收治的79例新生儿骶尾部畸胎瘤,对临床表现、辅助检查、手术及病理,以及术后并发症的预防进行分析。结果 79例中男37例,女42例;年龄3～28d,临床分型:显型51例,隐型9例,混合型19例。均行手术切除肿瘤。术后合并切口感染17例,直肠损伤合并肠瘘2例,均经综合治疗治愈;没有直肠脱垂及大便失禁并发症。病理检查7例为恶性,占8%,72例为良性,占91%。随访3月～5年,复发者8例,占10.12%,5例查甲胎球蛋白(AFP)大于250ng/L,考虑恶性复发,4例原病理检查即为恶性。2例AFP小于250ng/L,行二次手术治愈。结论新生儿骶尾部畸胎瘤良性居多,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 79 neonates with sacrococcygeal teratoma treated in our hospital from January 2000 to January 2010 was performed to analyze the clinical manifestations, auxiliary examinations, surgery and pathology, and the prevention of postoperative complications. Results There were 37 males and 42 females in 79 cases. The age was from 3 to 28 days. There were 51 cases of obvious type, 9 cases of latent type and 19 cases of mixed type. Surgical resection of the tumor. Postoperative infection incision infection in 17 cases, rectal injury with intestinal fistula in 2 cases, were cured by comprehensive treatment; no rectal prolapse and fecal incontinence complications. Pathological examination in 7 cases was malignant, accounting for 8%, 72 cases were benign, accounting for 91%. Follow-up ranged from 3 months to 5 years, 8 cases were recurrence, accounting for 10.12%. AFP was more than 250ng / L in 5 cases. Malignant recurrence was considered in 5 cases, and malignant in 4 cases. 2 cases of AFP less than 250ng / L, the line of second cure. Conclusions Neonatal sacrococcygeal teratoma is benign, the complete removal of the tumor and the removal of the coccyx are the key to reduce the tumor recurrence and malignant transformation. The good intraoperative pelvic floor structure can prevent postoperative fecal incontinence and rectal prolapse. Prone position and wound suction suction and other measures to reduce incision infection.