小儿原发性睾丸肿瘤47例诊治分析

发布时间：2018-02-01 15:59

本文关键词： 睾丸肿瘤诊断治疗儿童　出处：《广西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的:探讨小儿原发性睾丸肿瘤的临床表现及诊断治疗经验。材料与方法:对2003年01月至2011年12月在广西医科大学第一附属医院小儿外科住院手术诊治的原发性睾丸肿瘤患儿行回顾性分析。将患儿年龄、临床表现、B超检查、血清AFP、病理类型、治疗和预后加以分析。统计学采用卡方检验及Kaplan-Meier生存分析，以α=0.05为显著性检验水准。结果:47例小儿原发性睾丸肿瘤，患儿年龄从6天~13岁不等，3岁前发病38例(80.85%)。患儿病程在6天～1年不等，其中病程6个月内41例(87.23%)。良、恶性小儿原发性睾丸肿瘤左、右侧发病无显著差异(P0.05)，双侧睾丸肿瘤少见。良恶性小儿原发性睾丸肿瘤间血清AFP及超声检查肿块性质差异显著(P0.05)。成熟畸胎瘤，术后有7例获得随访。卵黄囊瘤，术后26例获得随访，其中I期16例，II期2例，III期6例，IV期2例。结论： 1.小儿睾丸肿瘤少见，临床上主要表现阴囊无痛性肿块，单侧发病多见，左、右侧无显著差异，双侧发病极少。 2.血清AFP、超声检查对小儿睾丸肿瘤良恶性的鉴别、肿瘤分期及判断肿瘤是否转移和复发具有重要的价值。 3.小儿睾丸肿瘤多为卵黄囊瘤，畸胎瘤次之。 4.成熟畸胎瘤行保留睾丸的肿瘤剔除术是有意义的。 5.小儿卵黄囊瘤以睾丸根治性切除术治疗为主，无论I期或II~IV期，术后辅助的化疗均有意义。
[Abstract]:Objective: to investigate the clinical manifestations and diagnosis and treatment of primary testicular tumors in children. Materials and methods:. Children with primary testicular tumor treated in pediatric surgery from January 2003 to December 2011 in the first affiliated Hospital of Guangxi Medical University were analyzed retrospectively. Clinical manifestation, B-ultrasound examination, serum AFP, pathological type, treatment and prognosis were analyzed. Chi-square test and Kaplan-Meier survival analysis were used in statistics. The significant test level was 伪 -0. 05. Results among 47 children with primary testicular tumor, 38 cases with primary testicular tumor occurred before 3 years of age, ranging from 6 days to 13 years old. The course of disease ranged from 6 days to 1 year. There were 41 cases with benign or malignant primary testicular tumors within 6 months. There was no significant difference in the incidence of left and right testicular tumors (P 0.05). Bilateral testicular tumors were rare. There were significant differences in serum AFP and ultrasound between benign and malignant children with primary testicular tumors (P 0.05). Mature teratoma was followed up in 7 cases after operation and yolk sac tumor. 26 cases were followed up after operation, including 16 cases in stage I, 2 cases in stage II, 6 cases in stage III and 2 cases in stage IV. Conclusion: 1. Testicular neoplasms are rare in children. The main clinical manifestations are painless scrotal masses. 2. Serum AFP and ultrasonic examination have important value in differentiating benign and malignant testicular tumors, staging tumor and judging tumor metastasis and recurrence in children. 3. Testicular tumors in children were mostly yolk sac tumors, followed by teratoma. 4. Testicular preserving tumor removal is meaningful for mature teratoma. 5. The treatment of yolk sac tumor in children was mainly radical testicular excision. The postoperative adjuvant chemotherapy was significant in both stage I and II~IV.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R737.21

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