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目的通过总结我院收治的25例新生儿腹部实体肿瘤的临床资料,探讨新生儿腹部实体肿瘤的诊治经验。方法回顾分析1980年1月~2003年12月治疗25例新生儿腹部实体肿瘤,男15例,女10例,年龄从出生后3~30d,出生前经B超诊断胎儿腹部占位性病变9例,占36.0%,恶性实体瘤13例,占52.0%。肝母细胞瘤7例,肝错构瘤2例,神经母细胞瘤5例,先天性中胚层肾瘤2例,腹膜后良性畸胎瘤4例,胃恶性畸胎瘤1例,卵巢囊肿2例,肾上腺错构瘤1例,肾上腺腺瘤1例。肿瘤完整切除20例,肿瘤部分切除1例,仅行肿瘤活检4例。结果肝母细胞瘤存活2例,死于化疗毒副反应1例,失访4例,肝错构瘤生存2例,神经母细胞瘤生存4例,死于化疗毒副反应1例。除1例胃恶性畸胎瘤术后失访外,其余病例均长期生存。结论新生儿腹部实体肿瘤罕见,但通过产前B超可早期发现,出生后小儿外科医师应早期介入,根据病种采取合理检查及治疗手段,包括早期手术,术后合理、规范的化疗,可提高患儿的救治率。
Objective To summarize the clinical data of 25 cases of neonatal abdominal solid tumors admitted to our hospital to discuss the diagnosis and treatment of neonatal abdominal solid tumors. Methods Retrospective analysis of January 1980 ~ December 2003 treatment of 25 cases of neonatal solid tumors of the abdomen, 15 males and 10 females, aged from 3 to 30 days after birth, before birth by B ultrasound diagnosis of fetal abdominal lesions 9 Cases, accounting for 36.0%, 13 cases of malignant solid tumors, accounting for 52.0%. 7 cases of hepatoblastoma, 2 cases of hepatic hamartoma, 5 cases of neuroblastoma, 2 cases of congenital mesodermal neoplasia, 4 cases of retroperitoneal teratoma, 1 case of gastric malignant teratoma, 2 cases of ovarian cyst 2 For example, adrenal hamartoma in 1 case, adrenal adenoma in 1 case. Complete tumor resection in 20 cases, partial resection of the tumor in 1 case, only 4 cases of tumor biopsy. Results Hepatoblastoma survived in 2 cases, died of chemotherapeutic toxicities in 1 case, lost in 4 cases, hepatic hamartoma survived in 2 cases, neuroblastoma in 4 cases and died of chemotherapy in 1 case. In addition to a case of gastric malignant teratoma lost after surgery, the remaining cases were long-term survival. Conclusion Neonatal abdominal solid tumors are rare, but prenatal B ultrasound can be found early, after birth pediatric surgeons should be involved early, according to the disease to take reasonable examination and treatment, including early surgery, postoperative rational and standardized chemotherapy, Improve the treatment rate in children.