视网膜母细胞瘤36例临床观察分析
摘要
目的
观察分析目前我院视网膜母细胞瘤(retinoblastoma, Rb)患者的临床诊治情况。
方法
对我院2010年3月～2012年3月所收治的36例45眼Rb患者的临床资料进行观察分析。记录并分析Rb的分期、患者的确诊年龄、性别比例、来源分布、发现症状至诊断的时间、就诊症状、治疗方法和预后。
结果
36例45眼Rb患儿中,单眼患病27例、双眼患病9例,双眼患病占25%。男性患者17例,女性患者19例,男：女为1：1.12。按照国内Rb分期：眼内生长期23眼(51.11%),青光眼期20眼(44.44%),眼外期眼2眼(4.44%),无全身转移病例。按照IRC分期：B期6眼(13.95%),C期5眼(11.63%),D期1眼(2.33%),E期31眼(72.09%),2眼不能进行眼内分期。患者的确诊年龄平均为(26.14±18.32)m,单眼患病的确诊年龄(28.85±19.29)m(范围：1-84m),双眼患病的确诊年龄(18.00±12.63)m(范围：6-48m)。发现症状至诊治时间为(3.52±2.90)m,单眼为(3.12±2.38)m(范围：0.33-10m),双眼为(4.72±4.04)m(范围：1HU言#1～12m),单眼与双眼患病组发现症状至就诊时间的差异无统计学意义(p>0.05；Mann-Whitney检验)。白瞳症为最常见的就诊症状,占66.67%。放弃治疗2例4眼,保守治疗11眼,眼球摘除30眼(73.17%)
结论
本组Rb患者就诊较晚且病情较严重,E期所占比例最大,保守治疗率较低、眼球摘除率高。
Objective
To observe and analyze the clinical characteristics of patients with retinoblastoma(Rb).
Methods
The medical records of patients with retinoblastoma from March2010. to March2012were observed and analysed in the First Teaching Hospital of Zhengzhou University. Items attended including the stages, gender, area of sources, presenting signs,interval between first symptoms and clinical diagnosis, treatments and prognosis.
Results
Among36children (17males and19females) with retinoblastoma,27(75%) had unilateral and9(25%) had bilateral disease. The clinical features were commensurated
with domestic stage as'tumor confied intraocular without glaucomatous signs'in23(51.11%) eyes, as'glaucomatous stage'in20(44.44%) eyes, as'extraocular stage' in2(4.44%) eyes and0with metastases. Six eyes presented with Murphree stage B,5with C,1with D,31with E and2presented with extraocular stage. The mean age at diagnosis of retinoblastoma was (26.14±18.32) months(range:1-84months), and was (28.85±19.29) months(range:1-84months) in the group with unilateral retinoblastomas and (18.00±12.63) months(range:6-48months) in the group with bilateral retinoblastomas. Mean interval between first symptoms and clinical diagnosis was (3.52±2.90) months(range:0.33-12months). This interval did not vary significantly (P>0.05, Mann-Whitney test) between the group with unilateral retinoblastomas (3.12±2.38months, range:0.33-10months) and the group with bilateral retinoblastomas (4.72±4.04months, range:1-12months). Leukokoria was the most frequent presenting signs in30/45(66.67%).4eyes abandoned treatment, Conservative treatment was in11eyes (26.83%), the enucleation was in30eyes (73.17%).
Conclusion
In our research, retinoblastoma is characterized by late stage and a higher rate of enucleation compared with the rate of conservative treatment.
观察分析目前我院视网膜母细胞瘤(retinoblastoma, Rb)患者的临床诊治情况。
方法
对我院2010年3月～2012年3月所收治的36例45眼Rb患者的临床资料进行观察分析。记录并分析Rb的分期、患者的确诊年龄、性别比例、来源分布、发现症状至诊断的时间、就诊症状、治疗方法和预后。
结果
36例45眼Rb患儿中,单眼患病27例、双眼患病9例,双眼患病占25%。男性患者17例,女性患者19例,男：女为1：1.12。按照国内Rb分期：眼内生长期23眼(51.11%),青光眼期20眼(44.44%),眼外期眼2眼(4.44%),无全身转移病例。按照IRC分期：B期6眼(13.95%),C期5眼(11.63%),D期1眼(2.33%),E期31眼(72.09%),2眼不能进行眼内分期。患者的确诊年龄平均为(26.14±18.32)m,单眼患病的确诊年龄(28.85±19.29)m(范围：1-84m),双眼患病的确诊年龄(18.00±12.63)m(范围：6-48m)。发现症状至诊治时间为(3.52±2.90)m,单眼为(3.12±2.38)m(范围：0.33-10m),双眼为(4.72±4.04)m(范围：1HU言#1～12m),单眼与双眼患病组发现症状至就诊时间的差异无统计学意义(p>0.05；Mann-Whitney检验)。白瞳症为最常见的就诊症状,占66.67%。放弃治疗2例4眼,保守治疗11眼,眼球摘除30眼(73.17%)
结论
本组Rb患者就诊较晚且病情较严重,E期所占比例最大,保守治疗率较低、眼球摘除率高。
Objective
To observe and analyze the clinical characteristics of patients with retinoblastoma(Rb).
Methods
The medical records of patients with retinoblastoma from March2010. to March2012were observed and analysed in the First Teaching Hospital of Zhengzhou University. Items attended including the stages, gender, area of sources, presenting signs,interval between first symptoms and clinical diagnosis, treatments and prognosis.
Results
Among36children (17males and19females) with retinoblastoma,27(75%) had unilateral and9(25%) had bilateral disease. The clinical features were commensurated
with domestic stage as'tumor confied intraocular without glaucomatous signs'in23(51.11%) eyes, as'glaucomatous stage'in20(44.44%) eyes, as'extraocular stage' in2(4.44%) eyes and0with metastases. Six eyes presented with Murphree stage B,5with C,1with D,31with E and2presented with extraocular stage. The mean age at diagnosis of retinoblastoma was (26.14±18.32) months(range:1-84months), and was (28.85±19.29) months(range:1-84months) in the group with unilateral retinoblastomas and (18.00±12.63) months(range:6-48months) in the group with bilateral retinoblastomas. Mean interval between first symptoms and clinical diagnosis was (3.52±2.90) months(range:0.33-12months). This interval did not vary significantly (P>0.05, Mann-Whitney test) between the group with unilateral retinoblastomas (3.12±2.38months, range:0.33-10months) and the group with bilateral retinoblastomas (4.72±4.04months, range:1-12months). Leukokoria was the most frequent presenting signs in30/45(66.67%).4eyes abandoned treatment, Conservative treatment was in11eyes (26.83%), the enucleation was in30eyes (73.17%).
Conclusion
In our research, retinoblastoma is characterized by late stage and a higher rate of enucleation compared with the rate of conservative treatment.
引文
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