本文關(guān)鍵詞： 睪丸腫瘤 診斷 治療 兒童　出處：《廣西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討小兒原發(fā)性睪丸腫瘤的臨床表現(xiàn)及診斷治療經(jīng)驗(yàn)。 材料與方法:對(duì)2003年01月至2011年12月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院小兒外科住院手術(shù)診治的原發(fā)性睪丸腫瘤患兒行回顧性分析。將患兒年齡、臨床表現(xiàn)、B超檢查、血清AFP、病理類型、治療和預(yù)后加以分析。統(tǒng)計(jì)學(xué)采用卡方檢驗(yàn)及Kaplan-Meier生存分析，以α=0.05為顯著性檢驗(yàn)水準(zhǔn)。 結(jié)果:47例小兒原發(fā)性睪丸腫瘤，患兒年齡從6天~13歲不等，3歲前發(fā)病38例(80.85%)。患兒病程在6天～1年不等，其中病程6個(gè)月內(nèi)41例(87.23%)。良、惡性小兒原發(fā)性睪丸腫瘤左、右側(cè)發(fā)病無(wú)顯著差異(P0.05)，雙側(cè)睪丸腫瘤少見。良惡性小兒原發(fā)性睪丸腫瘤間血清AFP及超聲檢查腫塊性質(zhì)差異顯著(P0.05)。成熟畸胎瘤，術(shù)后有7例獲得隨訪。卵黃囊瘤，術(shù)后26例獲得隨訪，其中I期16例，II期2例，III期6例，IV期2例。 結(jié)論： 1.小兒睪丸腫瘤少見，臨床上主要表現(xiàn)陰囊無(wú)痛性腫塊，單側(cè)發(fā)病多見，左、右側(cè)無(wú)顯著差異，雙側(cè)發(fā)病極少。 2.血清AFP、超聲檢查對(duì)小兒睪丸腫瘤良惡性的鑒別、腫瘤分期及判斷腫瘤是否轉(zhuǎn)移和復(fù)發(fā)具有重要的價(jià)值。 3.小兒睪丸腫瘤多為卵黃囊瘤，畸胎瘤次之。 4.成熟畸胎瘤行保留睪丸的腫瘤剔除術(shù)是有意義的。 5.小兒卵黃囊瘤以睪丸根治性切除術(shù)治療為主，無(wú)論I期或II~IV期，術(shù)后輔助的化療均有意義。
[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 偽 -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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R737.21

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本文編號(hào)：1482250