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目的:探讨良性对称性脂肪瘤病(BSL)的诊断和治疗。方法:结合我院收治的6例BSL患者,回顾性分析BSL的临床症状、体征、诊断及治疗,并结合文献进行探讨。结果:6例均以颈项部大量皮下脂肪堆积为主要表现,其中1例伴有双侧上臂近肘窝处皮下脂肪堆积呈对称性隆起。6例患者伴左心舒张功能改变、糖耐量减低、阻塞性睡眠呼吸暂停低通气综合征、Ⅱ型糖尿病及高尿酸血症中的1项或多项,其中1例患者同时出现上述症状,除1例女性患者未见肝功能改变外其余5例男性患者均出现。5例男性患者均有长期酗酒史。除1例拒绝治疗外,其余5例行彻底切除术及戒酒,术后随访3个月～4年,1例术后3年后复发,未行再次治疗,其余4例无复发。所有患者术后病理诊断为无包膜脂肪组织。结论:BSL是一种脂肪代谢障碍引起的脂肪组织弥漫性、对称性沉积于颈肩部皮下浅筋膜间隙和(或)深筋膜间隙的良性疾病。患者以中年男性居多,长期的酗酒史及典型的临床表现对于该病的诊断有一定帮助,对于影响美观及功能的患者手术疗效较理想。
Objective: To investigate the diagnosis and treatment of benign symmetrical lipoma (BSL). Methods: The clinical symptoms, signs, diagnosis and treatment of BSL were retrospectively analyzed in combination with 6 cases of BSL admitted in our hospital. Results: The majority of the 6 cases were mainly subcutaneous fat accumulation in the neck area. Among them, 1 case had subcutaneous fat accumulation near the elbow of the upper arm with symmetrical bumps. 6 patients with left ventricular diastolic function, impaired glucose tolerance, obstructive sleep apnea-hypopnea syndrome, type II diabetes mellitus and hyperuricemia in one or more, including 1 patients with the above symptoms, in addition to One case of female patients without liver function changes in the remaining five cases of male patients. 5 male patients have a long history of alcohol abuse. In addition to one case of refusal treatment, the remaining 5 cases underwent radical resection and alcohol abstinence. The patients were followed up for 3 months to 4 years. One patient relapsed after 3 years and no further treatment was performed. The remaining 4 patients had no recurrence. All patients were pathologically diagnosed as non-enveloped adipose tissue. CONCLUSIONS: BSL is a benign disease of fat tissue diffuse and symmetrically deposited on the subfascial superficial fascia and / or deep fascia in the neck and shoulder. Patients are mostly middle-aged men, a long history of alcohol abuse and typical clinical manifestations for the diagnosis of the disease have some help, affect the appearance and function of patients with better surgical results.