儿童腹腔淋巴管瘤相关并发症的诊治体会

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目的:探讨儿童腹腔淋巴管瘤相关并发症的诊治经验。方法:选取2016年1月至2020年1月安徽省儿童医院收治的腹腔淋巴管瘤继发并发症患儿18例,对其临床表现、影像学特点、诊治经过及预后进行回顾性分析。结果:18例患儿中,腹腔淋巴管瘤继发感染4例,出血3例,破裂2例,肠梗阻9例。初诊超声确诊13例,CT确诊16例。2例腹腔淋巴管瘤继发感染和1例淋巴管瘤破裂患儿先行保守治疗,病情稳定后再行根治性手术;1例横结肠系膜巨大淋巴管瘤伴感染的患儿先急诊行囊肿外引流术,2个月后行手术切除肿瘤;其余14例患儿均行一期手术治疗。手术过程顺利,其中行单孔腹腔镜辅助手术8例,开放手术10例。术后恢复满意,无乳糜漏等并发症发生。术后住院时间(6.6 ± 1.8)d,其中单孔腹腔镜辅助手术后住院时间(5.4 ± 1.4)d,开腹手术后住院时间(7.6 ± 1.6)d。患儿术后随访3个月至2年,无一例复发。结论:儿童腹腔淋巴管瘤出现并发症临床较少见,腹部超声和CT可作为常规检查评估病情,手术治疗安全有效,选择个体化的手术时机和手术方式可使患儿获得良好的预后。“,”Objective:To summarize the diagnosis and treatment of complications related to abdominal lymphangioma in children.Methods:The clinical data of 18 children with complications related to abdominal lymphangioma in Anhui Provincial Children′s Hospital from January 2016 to January 2020 were collected. The clinical manifestations, radiological characteristics, diagnosis, treatment and prognosis were retrospectively analyzed.Results:Among the 18 children, there were 4 cases with secondary infection, 3 cases with hemorrhage, 2 cases with rupture and 9 cases with intestinal obstruction. The ultrasonic diagnosis was accurately in 13 cases, and CT diagnosis was accurately in 16 cases. Conservative treatment was performed first for 2 cases with secondary infection and 1 case with rupture, and then radical operation was performed after the condition was stable. One case with macrosis lymphangioma of transverse colon complicated with infection underwent cyst external drainage in emergency first, and surgical resection of the tumor was carried out after 2 months. The other 14 cases were treated with one-stage radical operation, and the operation was successfully. There were 8 cases with single port laparoscopic assisted operation and 10 cases with open operation. Postoperative recovery was satisfactory and no complications such as chylous leakage occurred. The hospital stays after operation was (6.6 ± 1.8) d, among which the hospital stays after operation of single port laparoscopic assisted operation was (5.4 ± 1.4) d, and open operation was (7.6 ± 1.6) d. All children were followed up for 3 months to 2 years, and no single case recurred.Conclusions:Complications of abdominal lymphangioma in children are rare. Abdominal ultrasound and CT can be used as routine examination to evaluate the condition of the disease. The operation is a safe and effective procedure in clinical practice. The individualized treatment measures should be chosen according to the clinical condition.
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