25例脾脏肿瘤临床分析

Clinical analysis of 25 cases of splenic neoplasms

目的 提高对脾脏肿瘤的诊治水平。方法 对25例脾脏肿瘤进行回顾性分析。结果 脾脏良性肿瘤病史一般超过半年,而恶性肿瘤则短于半年。B超首诊占40％(10/25),CT诊断的准确率超过B超,良性肿瘤13例行脾切除术,6例行脾部分切除术+脾移植。6例恶性肿瘤行脾切除术或广泛切除+化疗。25例脾切除术术后无一例死亡,亦未发现术后并发症。良性肿瘤全部治愈。恶性肿瘤3例,分别随访1年6个月,3年及3年8个月,患者仍然存活,失访3例。结论 原发性脾脏肿瘤在临床上罕见。良性肿瘤症状隐匿,病史长;恶性肿瘤病史短,伴有发热、消瘦、贫血。B超检查应作为首选方法。良性肿瘤尽量行保脾手术,恶性肿瘤行脾切除+化疗。

Objective To improve the level of the diagnosis and treatment of splenic tumor. Methods 25 cases of splenic tumors were analyzed retrospectively. ResultS In most cases, the history of benign tumors were longer than 6 months, while less than 6 months in malignant tumors. 40%of cases were diagnosed by ultrasonography initially, and CT scan was more reliable than ultrasonography. Splenectomy was performed in 13 cases of benign tumors, Partial splenecto-my plus splenic graft in 6 cases. Splenectomy or extensive resection plus chemotherapy were performed in 6 cases of malignant tumors. No death and complication were found in any cases. Benign tumor was cured. In the follow-up 3 cases of malignant tumors, that was stili survival 18 months, 36 months and 44 months respectively. Conclusion Primary splenic tumor is a uncommon disease. The early symptoms of the benign tumor was obscure and it had a longer history. But the malignant tumor had a short history and accompanied with fever, anemia and emaciation. Ultrasonography is a basie exammed method. A spleen saving operation is recommended for benign tumor and splenectomy plus chemotherapy for malignant tumor.