摘要
目的探讨原发性脾脏肿瘤的诊断与治疗。方法选取2006年1月-2014年12月期间收治的58例原发脾脏肿瘤患者进行临床观察。结果脾脏良性肿瘤45例，其中脾血管瘤21例，脾囊肿11例，脾淋巴管瘤8例，脾脏窦岸细胞血管瘤3例，脾错构瘤1例，脾脏硬化性血管瘤样结节性转化1例；脾脏恶性肿瘤13例，其中脾脏B细胞淋巴瘤11例，脾脏霍奇金淋巴瘤及脾脏血管肉瘤各1例。B超和CT是主要的检查方法。全组行脾切除术51例，其中开腹脾切除术23例，腹腔镜脾切除术28例；部分脾切除术5例；脾切除＋胰腺体尾部切除术2例。所有病例无手术并发症。术后随访9个月～9年，平均随访时间（43．8±21．3）个月，41例脾脏良性肿瘤患者预后良好，无复发和转移；11例脾脏恶性肿瘤患者的1、3、5年生存率分别为81．8％、63．6％和27．2％。结论原发性脾脏肿瘤的诊断主要依靠临床表现和影像学检查。手术切除不仅是脾脏肿瘤一种有效的治疗手段，也是重要的确诊方法。脾脏局限性良性肿瘤可选择部分脾切除术以保留脾脏功能。早期手术及术后联合放化疗可改善脾脏恶性肿瘤的预后。
Objective To investigate the diagnosis and treatment of primary splenic tumor. Methods The clinical data of 58 patients with primary splenic tumor from January 2006 to December 2014 were retrospectively analyzed. Results 45 cases were benign splenic tumor, including 21 hemangioma, 11 splenic cyst, 8 lymphangioma, 3 littoral cell angioma, 1 hamartoma and 1 sclerosing angiomatoid nodular transformation of spleen. 13 cases were malignant splenic tumor, including 12 lymphoma and 1 angiosarcoma. Ultrasound and CT were the main diagnostic methods. 51 cases underwent splenectomy, including 23 open splenectomy and 28 laparoscopic splenectomy. 5 cases underwent partial splenectomy and 2 splenectomy combined distal pancreatectomy. There had no postoperative complications. The follow-up period was 9 months to 9 years. 41 cases with benign splenic tumor had no recurrence or metastasis. The 1-, 3-, 5-years survival rate were 81.8% , 63.6% and 27. 2% respectively of 11 patients with malignant splenic tumor. Conclusion The diagnostic of primary splenic tumor mostly rely on clinical features and imagic examination. Surgical resection is not only an effective treatment, but also a confirmed diagnosis method for primary splenic tumor. Partial splenectomy is a reasonable procedure for local benign splenic tumor. Early surgery, combined adjuvant chemotherapy and radiotherapy are important for improving the prognosis of malignant splenic tumor.
出处
《广州医药》
2016年第1期44-46,共3页
Guangzhou Medical Journal
关键词
脾脏肿瘤
诊断
治疗
Primary splenic tumor
Diagnosis
Treatment
