口腔医学研究 ›› 2019, Vol. 35 ›› Issue (11): 1052-1056.DOI: 10.13701/j.cnki.kqyxyj.2019.11.011

• 口腔颌面外科学研究 • 上一篇    下一篇

15例马德隆病的临床回顾分析

马于斐, 赵志国, 黄怡怡, 刘维贤*   

  1. 中国医科大学附属盛京医院口腔颌面外科 辽宁 沈阳 110004
  • 收稿日期:2019-03-01 出版日期:2019-11-28 发布日期:2019-11-21
  • 通讯作者: 刘维贤,E-mail: liuwx@sj-hospital.org
  • 作者简介:马于斐(1990~ ),男,湖北荆州人,硕士,住院医师,研究方向:口腔颌面部肿瘤。
  • 基金资助:
    高等学校博士点基金(编号:20132014110012)

Clinical Retrospective Analysis of 15 Cases of Madelung's Disease

MA Yufei, ZHAO Zhiguo, HUANG Yiyi, LIU Weixian*   

  1. Department of Oral and Maxillofacial Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
  • Received:2019-03-01 Online:2019-11-28 Published:2019-11-21

摘要: 目的: 研究马德隆病的临床、影像学特点、治疗方法及预后因素。方法: 对马德隆病的发病部位、临床表观、实验室检查结果、影像学特点、治疗方法和预后情况进行回顾分析。结果: 马德隆病男女比14:1,平均年龄(52.1±6.7)岁,84.6%患者有大量长期饮酒史,80%发病于颈项部。69.2%患者出现肝功能异常,以γ-谷氨酰基转移酶升高为主,其中88.8%患者有饮酒史。主要表现为肿物弥漫性对称性分布,无痛缓慢生长,与周围组织界限不清。CT及MR见皮下脂肪对称性大量堆积,无包膜,界限不清,可见条索状或网状纤维间隔,邻近肌肉及腺体受压移位、萎缩、变形,10例患者出现了不同程度颈椎间盘突出及颈椎退行性改变,14例患者均采用开放性手术切除,2例患者出现术后并发症,4例患者术后复发。结论: 马德隆病好发于中年男性,大量饮酒是马德隆病的诱发因素之一。病变主要发生于颈项部及肩胛区,患者多伴有肝功能异常主要由大量饮酒所致。CT及MRI对马德隆病诊断及治疗具有重要指导意义,患者多伴有颈椎病变,开放性手术切除术能显著改善患者形态及功能。马德隆病患者术后饮酒复发率高。

关键词: 马德隆病, 临床特点, 影像学特点, 治疗方法, 预后因素

Abstract: Objective: To study the clinical and imaging features, treatment, and prognostic factors of Madelung's disease. Methods: The location, clinical appearance, laboratory findings, imaging features, treatment, and prognosis of Madelung's disease were retrospectively analyzed. Results: Male-to-female ratio of Madelung's disease was 14:1, with an average age of (52.1±6.7)years. 84.6% of the patients had a long-term drinking history, and 80% of them occurred in anterior cervical region and neck region. 69.2% of the patients had abnormal liver function, mainly with elevated gamma-glutamyltransferase, of which 88.8% had a history of drinking. The main manifestation was the diffuse symmetry distribution of the tumor, painless and slow growth, and the boundary with the surrounding tissue was unclear. CT and MR showed symmetrical accumulation of subcutaneous fat without envelope, unclear boundaries, linear or reticular fibrous septum, compression, displacement, atrophy and deformation of adjacent muscles and glands. 10 patients had different degrees of cervical disc herniation and cervical degenerative changes. Fourteen patients underwent open surgical resection, 2 patients had postoperative complications. Four patients had recurrence after operation. Conclusion: Madelung's disease is predominant in middle-aged males. Heavy drinking is one of the inducing factors of Madelung's disease. The lesions mainly occur in the neck and scapula. Most patients with liver dysfunction are mainly caused by heavy drinking. CT and MRI play an important role in the diagnosis and treatment of Madelung's disease. Most patients have cervical spondylosis. Open surgical resection can significantly improve the patient's morphology and function. High recurrence rate of alcohol consumption occurs in patients with Madelung's disease after operation.

Key words: Madelung's disease, clinical features, imaging features, treatment methods, prognostic factors