脾海绵状血管瘤的诊治体会

Splenic hemangioma： presentation, diagnosis, and management

目的了解脾海绵状血管瘤的临床特点及诊断、治疗要点。方法回顾性分析总结1989年4月至2007年7月间21例脾海绵状血管瘤的临床表现、辅助检查（实验室检查、影像学检查、病理学检查）以及治疗结果和预后情况。结果脾海绵状血管瘤的临床表现缺乏特异性，主要症状为左上腹部包块、左上腹不适、腹痛等。检查手段包括B超、CT、MRI、血管造影等。脾海绵状血管瘤最主要的治疗方法是脾切除。结论脾海绵状血管瘤瘤体较大（直径〉4cm）或有症状的患者，可以进行脾手术切除，术式可以开腹脾切除，也可以手助腹腔镜脾切除；对于没有临床症状、肿瘤较小的患者，可以进行密切的观察随访。

Objective To evaluate the clinical features and the key points in the diagnosis and management of splenic hemangioma. Methods The clinical presentations, laboratory tests, imaging and pathological results, treatment, and prognosis of 21 cases of splenic hemangioma admitted in Peking Union Medical College Hospital from April, 1989 to July 2007 were retrospectively analyzed. Results The clinical presentations of splenic hemangiom are not specific which include left upper quadrant mass or discomfort, abdominal pain, etc. The diagnosis of imaging includes Doppler ultrasound, CT, MRI, DSA, etc. Splencetomy is recommended for all splenic hemangioma with severe symptoms or rupture. Conclusion Asymptomatic patients with small splenic hemangioma （ 〈 4 cm ） can be managed conservatively. Symptomatic large hamangioma may need a splenectomy.