探讨手部淋巴管瘤的诊断要点和手术治疗的效果。

收集2013年1月至2018年1月徐州仁慈医院收治的7例手部淋巴管瘤患者资料，其中男性3例，女性4例；年龄5~33岁，平均19.6岁；肿瘤位于手背4例，手腕1例，手指2例；首发症状均为无痛性肿物，肿物范围（5.0 cm×6.0 cm×0.5 cm）~（11.0 cm×15.0 cm×1.5 cm），3例肿物体积有波动性变化的特点。所有患者均在显微镜下彻底切除肿瘤，切口均直接缝合，术后随访，末次随访参照Enneking骨骼肌肉肿瘤术后四肢功能评定标准评价患肢功能情况。

本组7例患者均行显微外科手术治疗，术后病理均证实为淋巴管瘤，手术平均用时为95.5 min，切口愈合平均时间为15.3 d。本组患者早期1例切口1.0 cm×2.5 cm皮肤坏死，经换药后延期愈合，1例术后3 d出现淋巴漏，经再次清创缝合伤口后愈合，其余5例切口均一期愈合。7例均获随访，平均随访时间25.6个月，末次随访患肢功能评分为17~28分，平均25.3分，功能评定优5例，良1例，中1例，优良率为85.7%（6/7）。

手部淋巴管瘤症状常为无痛性肿物，肿物体积可呈波动性变化，显微外科手术可实现肿瘤彻底切除，减少损伤及复发，有利于肢体功能恢复。

To investigate the diagnosis and microsurgical treatment of hand lymphangioma.

From January 2013 to January 2018, seven cases of lymphangioma of the hand were treated at Xuzhou Renci Hospital, including three males and four females, with an average age of 23.6 years (range, 11-33 years). Four cases were located on the back of the hand, one on the wrist, and two on the fingers. The first symptoms were all a painless mass, measuring from 5.0 cm×6.0 cm×0.5 cm to 11.0 cm×15.0 cm×1.5 cm. The volume of the three masses had the characteristics of fluctuation. All the masses were resected under a microscope, and the incision was sutured directly. The function of the affected limb was evaluated according to the Enneking skeletal muscle tumor function scoring system after operation.

In this group of patients, microsurgery was performed. All the masses were proved to be lymphangioma by postoperative pathology. The average time of operation was 95.5 minutes, and the average time of incision healing was 15.3 days. One case developed incision (1.0 cm×2.5 cm) skin necrosis early after sugery, which healed after dressing change. One case developed lymphatic leakage 3 days after operation, which healed after debridement and suture again. The other five cases had satisfactory incision healing. The seven cases were followed for an average of 25.6 months, and the average score limb function score was 25.3 (range, 17-28), with a rate of excellent or good limb function of 85.7% (6/7).

The symptom of lymphangioma of the hand is usually a painless mass, and the volume of the mass may fluctuate. Microsurgery can preserve the subdermal vascular network of the incision skin, realize the precise resection of the tumor, reduce the injury and recurrence, and be conducive to the recovery of limb function.