脾脏占位性病变25例外科治疗经验

Surgical treatment of 25 patients with splenic tumor.

目的 总结脾脏占位性病变诊治的经验。方法 回顾性分析25 例脾脏占位性病变的病理类型以及诊断和治疗方法选择。结果 25 例脾脏占位性病变术前B 超诊断率为85 % (17/20) 。CT 鉴别良恶性正确率为82 % (9/11) 。20 例行脾切除,4 例肿块切除或脾部分切除,1 例活检。术后病理类型:良性占位性病变15 例(60 % ) ,恶性10 例(40 % ) 。恶性肿瘤中术后生存5 年以上2 例,均为早期病例。结论 影像检查是脾脏占位性病变的主要诊断手段。提高脾脏恶性肿瘤的早期诊断水平是改善预后的关键。

Objective To summarize the experiences of diagnosis and treatment of splenic tumors.Methods A retrospective study was performed.There were 25 cases of splenic tumor treated by surgical means in our hospital for 22 years recently.Results Fifteen among them were benign and other ten were malignant.The preoperative confirmed diagnostic rate by B-US was 85 percent.The preoperative discrimination rate of benign and malignant by CT was 82 percent.All the cases of benign and malignant tumor had curative effects by splenectomy or partial splenectomy.Two cases with malignant tumor had survived beyond 5 years,and they were in early stages.Conclusion Image examination is a main means of diagnosis for splenic tumors.Incipient diagnosis and treatment were important for improving the prognosis of splenic malignant tumor.