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| 題 名 | Surgical Approaches for Glomus Tumor of the Fingers and Toes=手指及腳趾血管脈絡球瘤之手術治療 |
|---|---|
| 作 者 | 陳彥瑋; 陳伊呈; 賴志昇; 呂俊德; 顏榮信; 宋定宇; | 書刊名 | 臺灣整形外科醫學會雜誌 |
| 卷 期 | 24:2 2015.06[民104.06] |
| 頁 次 | 頁93-104 |
| 分類號 | 415.641 |
| 關鍵詞 | 手指; 腳趾; 血管脈絡叢瘤; Subungual glomus tumor; Transungual approach; Eponychium extension; |
| 語 文 | 英文(English) |
| 中文摘要 | 背 景:血管脈絡叢瘤常發生在手指及腳趾的甲床下。他們會使受侵犯的指頭或腳趾疼痛及對低溫耐受性不佳。臨床上,我們使用三種檢驗方式來診斷,包括Love's pin test,Hildreth's test,及對低溫敏感測試。X光攝影、超音波攝影及核磁共振攝影均可用以幫助確診血管脈絡叢瘤。目的及目標:我們統計從2002年03月到2013年02月於台中榮民總醫院一系列病例因手指及腳趾之血管脈絡叢瘤從診斷到治療的探討。材料與方法:從2002年03月至2013年02月,總共34位病人患有手指或腳趾的血管脈絡叢瘤。其中有30位其腫瘤位於手指(88.2%),其餘四例位於腳趾(11.8%)。23位病人是女性(67.6%),另外11例是男性病人(32.4%)。平均年齡41.5歲(年齡介於21至73歲)。當藉由病史及身體理學檢查無法確診時,我們利用X光攝影、超音波攝影及核磁共振攝影來幫助鑑別診斷。我們以切開甲床合併翻開指甲上皮皮瓣的方式來切除腫瘤。其中有一個案,我們從外側切開皮膚進而移除腫瘤。結 果:33位患有手指或腳趾血管脈絡叢瘤的病人均接受切開甲床方式來移除腫瘤。另外一位病患乃由手指外側切開皮膚來移除腫瘤。術後幾天,全部病患均不再感覺疼痛且可以執行正常之日常生活工作。術後追蹤六年後,有兩位病患有腫瘤復發。結 論:臨床上,我們利用三種身體檢驗方式及影像學檢查來診斷手指及腳趾之血管脈絡叢瘤。經由合適的手術方式可以減少甲床其生發中心的傷害以及避免腫瘤再發的機率。經甲床切開來移除腫瘤的方式是可信賴且不錯的方式。 |
| 英文摘要 | Background: Glomus tumors commonly occur in the subungual region of the fingers and toes. They may cause subtle pain and cold intolerance of the involved fingers and toes. Clinical tests(classic triad) including Love's pin test, Hildreth's test and cold sensitivity test are helpful in the diagnosis of lesions. Radiography (X-ray), sonography and magnetic resonance imaging (MRI) can be applied for identification of glomus tumor. Aim and Objectives: We report a case series of glomus tumors of the fingers and toes from a single medical center. The diagnoses and the surgical approaches between Mar. 2002 and Feb. 2013 are described. Materials and Methods: Thirty-four patients diagnosed with glomus tumors at Taichung Veterans General Hospital (TCVGH) during the period from March 2002 to February 2013 were included in this study. Thirty glomus tumors were located in the fingers (88.2%) and four were located in the toes (11.8%). Twenty-three patients (67.6%) were women and eleven patients (32.4 %) were men. The average age of these patients was 41.5 years old (range from 21 to 73 years old). X-ray, sonography or MRI exams were applied when the diagnosis could not be confirmed by history and physical examination. We adopted a transungual approach for excision of tumors, including unilateral eponychium extension or bilateral eponychium extension. In one special case, lateral approach for excision of the tumor was employed. Results: All patients were clinically diagnosed with glomus tumors and excision by transungual approach was performed, except for one in lateral approach was adopted. The pathological diagnoses of glomus tumors were confirmed in all cases. All cases reported pain-free status within a few days post-surgery and returned to normal daily functioning within one week after removal of stitches. The follow-up period was from half a year to 11 years. Two patients (5.9%) had tumor recurrence, with an average disease-free interval of 6 years. Conclusion: Clinical diagnosis of the glomus tumor can be established by a combination of classic triad and imaging studies. The goal of tumor excision is to reduce damage to the nail bed and germinal matrix and to prevent tumor recurrence. Transungual approach for excision of glomus tumors is a reliable surgical method. |
本系統中英文摘要資訊取自各篇刊載內容。