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目的 探讨不同病理类型的原发性腹膜后肿瘤 (PRPT)的最佳诊断和治疗手段。方法 对经病理学证实的 2 4 4例PRPT的临床表现、病理类型、影像学检查和治疗进行回顾性分析总结。结果 ①PRPT中的主要症状为腹部包块 ( 61.3 % )和腹痛 ( 2 5.8% ) ;无症状早期病例 2 1例 ( 8.6% ) ;②恶性腹膜后肿瘤以平滑肌肉瘤、脂肪肉瘤和纤维肉瘤最多见 ,良性中以畸胎瘤最多见 ;③影像学检查腹部平片阳性发现率仅为 2 8.2 % ,消化道钡餐或钡剂灌肠检出率 68.7% ,B超检出率为 86.9% ,CT检查阳性发现率为 92 .1% ;④良性肿瘤手术完全切除率为 91.5% ,恶性肿瘤为 51.2 % ,无症状的恶性PRPT为 85.7% .结论 PRPT早期诊断困难 ,B超和CT是诊断PRPT的最好方法 ,手术切除是治疗PRPT的主要手段 ,对复发性PRPT应积极创造条件 ,争取再次手术
Objective To investigate the best diagnosis and treatment of primary retroperitoneal tumor (PRPT) of different pathological types. Methods The clinical manifestations, pathological types, imaging examination and treatment of 224 cases of PRPT confirmed by pathology were retrospectively analyzed and summarized. Results ① The main symptoms in PRPT were abdominal mass (61.3%) and abdominal pain (2 5.8%); asymptomatic early cases (21%) were 8.6%; ② malignant retroperitoneal tumors were mostly seen in leiomyosarcoma, liposarcoma and fibrosarcoma , Benign teratoma is the most common; ③ imaging examination abdominal plain positive rate was only 2 8.2%, barium or barium enema gastrointestinal 68.7% detection rate, B-detection rate was 86.9%, CT examination The positive detection rate was 92.1% .④The complete resection rate of benign tumor was 91.5%, the malignant tumor was 51.2%, and the asymptomatic malignant PRPT was 85.7% .Conclusion Early diagnosis of PRPT is difficult, A good method, surgical resection is the treatment of PRPT the main means of recurrent PRPT should actively create the conditions for reoperation