背部弹力纤维瘤50例临床分析(1)
[摘要] 目的 探讨背部弹力纤维瘤的诊断及治疗方法。 方法 回顾性分析2004年1月～2013年12月本院收治的50例背部弹力纤维瘤患者的临床资料，总结弹力纤维瘤的临床特点、特征性的影像学表现、典型性病理改变、近远期手术疗效。 结果 本组50例患者依据典型的发病部位(肩胛下角区域)及影像学(B超、MRI)检查而确诊，50例均行肿物切除术，肿物直径为4～12 cm。术后并发症主要为伤口积液，本组88处病变发生伤口积液25处，发生率28.4%，18处经反复穿刺抽液治愈，7处经腔内注射曲氨奈德治愈。术后随访6个月～10年，无复发。 结论 肩胛下角区域是背部弹力纤维瘤的主要发病部位。依据典型的体检结果及特征性影像学表现既可作出正确诊断。手术切除肿物的近、远期效果良好。
[关键词] 背部弹力纤维瘤；软组织肿瘤；彩色多普勒超声；外科手术
[中图分类号] R738.6 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0054-03
Clinical analysis of elastofibroma dorsi in 50 cases
HUANG Xiao-ming LONG Fei GOU Xiao-qing
Department of Orthopaedics，Changli People′s Hospital of Hebei Province，Changli 066600，China
[Abstract] Objective To explore the diagnostic and therapeutic methods of elastofibroma dorsi. Methods From January 2004 to December 2013，clinical data from 50 patients with elastofibroma dorsi admitted into our hospital were retrospectively analyzed.Clinical characteristic，distinctive imaging manifestation， typical pathological change，and curative effect in short/long-term surgery of elastofibroma dorsi were summarized. Results 50 participants were definitely diagnosed by typical pathogenic site (inferior angle of scapula region) and imageology examination (B-ultrasound and MRI).They were operated with neoplasms resection and the diameter of neoplasms ranged from 4 to 12 cm.The principal postoperative complication was wound hydrops in 25 wounds for 88 pathogenic sites occurred，and the incidence rate was 28.4%.Among them，18 sites were cured by repeated puncture and drainage，and 7 sites were cured by intracavitary injection of triamcinolone acetonide.Patients were followed up for 6 months to 10 years，and there was no recurrent case. Conclusion Area of inferior angle of scapula is a principal pathogenic site of elastofibroma dorsi，which can be correctly diagnosed by typical physical examination results and characterized imaging manifestations.Neoplasm is removed by surgery can obtain a good short/long-term effect.
[Key words] Elastofibroma dorsi；Soft tissue neoplasms；Color Doppler ultrasound；Surgical operation
弹力纤维瘤是临床少见的软组织肿瘤样病变，好发于肩胛骨下角部位，位于肩胛骨与胸壁之间，故称为背部弹力纤维瘤，好发于中老年女性，与肩部活动有密切关系，临床诊断容易，手术切除是唯一的治疗手段，术后复发率低，现将本院收治的背部弹力纤维瘤并经病理证实的50例分析报告如下。
1 资料与方法
1.1 一般资料
选取本院2004年1月～2013年12月收治的背部弹力纤维瘤并经病理证实的50例患者，其中女性36例，男性14例，女性占72%；年龄41～76岁，平均64.5岁；职业：农民43例，乡村教师5例，干部2例。双侧33例，单侧17例，双侧占66%。
1.2 临床诊断与鉴别诊断
特定的发病部位肩胛角部出现隆起的圆形或椭圆形肿物，肿物直径为3～12 cm，中等硬度，韧，边缘不清，无触痛，肩位于下垂位收紧肩时肿物不明显，肩关节屈曲内收时肿物更加明显，有时肩胛部伴有破裂声、撞击感和疼痛不适感，本组30例。本病应与脂肪瘤、纤维瘤、硬纤维瘤、纤维肉瘤、脂肪肉瘤、血管瘤等相鉴别，必要时行穿刺活检，本组病例均未做穿刺活检。 (黄晓明 龙飞 苟小清)
[关键词] 背部弹力纤维瘤；软组织肿瘤；彩色多普勒超声；外科手术
[中图分类号] R738.6 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0054-03
Clinical analysis of elastofibroma dorsi in 50 cases
HUANG Xiao-ming LONG Fei GOU Xiao-qing
Department of Orthopaedics，Changli People′s Hospital of Hebei Province，Changli 066600，China
[Abstract] Objective To explore the diagnostic and therapeutic methods of elastofibroma dorsi. Methods From January 2004 to December 2013，clinical data from 50 patients with elastofibroma dorsi admitted into our hospital were retrospectively analyzed.Clinical characteristic，distinctive imaging manifestation， typical pathological change，and curative effect in short/long-term surgery of elastofibroma dorsi were summarized. Results 50 participants were definitely diagnosed by typical pathogenic site (inferior angle of scapula region) and imageology examination (B-ultrasound and MRI).They were operated with neoplasms resection and the diameter of neoplasms ranged from 4 to 12 cm.The principal postoperative complication was wound hydrops in 25 wounds for 88 pathogenic sites occurred，and the incidence rate was 28.4%.Among them，18 sites were cured by repeated puncture and drainage，and 7 sites were cured by intracavitary injection of triamcinolone acetonide.Patients were followed up for 6 months to 10 years，and there was no recurrent case. Conclusion Area of inferior angle of scapula is a principal pathogenic site of elastofibroma dorsi，which can be correctly diagnosed by typical physical examination results and characterized imaging manifestations.Neoplasm is removed by surgery can obtain a good short/long-term effect.
[Key words] Elastofibroma dorsi；Soft tissue neoplasms；Color Doppler ultrasound；Surgical operation
弹力纤维瘤是临床少见的软组织肿瘤样病变，好发于肩胛骨下角部位，位于肩胛骨与胸壁之间，故称为背部弹力纤维瘤，好发于中老年女性，与肩部活动有密切关系，临床诊断容易，手术切除是唯一的治疗手段，术后复发率低，现将本院收治的背部弹力纤维瘤并经病理证实的50例分析报告如下。
1 资料与方法
1.1 一般资料
选取本院2004年1月～2013年12月收治的背部弹力纤维瘤并经病理证实的50例患者，其中女性36例，男性14例，女性占72%；年龄41～76岁，平均64.5岁；职业：农民43例，乡村教师5例，干部2例。双侧33例，单侧17例，双侧占66%。
1.2 临床诊断与鉴别诊断
特定的发病部位肩胛角部出现隆起的圆形或椭圆形肿物，肿物直径为3～12 cm，中等硬度，韧，边缘不清，无触痛，肩位于下垂位收紧肩时肿物不明显，肩关节屈曲内收时肿物更加明显，有时肩胛部伴有破裂声、撞击感和疼痛不适感，本组30例。本病应与脂肪瘤、纤维瘤、硬纤维瘤、纤维肉瘤、脂肪肉瘤、血管瘤等相鉴别，必要时行穿刺活检，本组病例均未做穿刺活检。 (黄晓明 龙飞 苟小清)