原发性脾占位性病变

Primary Splenic Space Occupying Lesion

目的 探讨原发性脾脏占位性病变的流行病学、诊断、鉴别诊断和治疗方法。方法 回顾性分析 195 8年 8月～ 1999年 12月收治的 31例原发性脾脏占位性病变患者的临床资料。结果 原发性脾脏占位性病变按其发病频率高低依次为 :脾海绵状血管瘤 ( 32 .3 % )、脾血管肉瘤 ( 19.4% )、脾局限性充血 ( 12 .9% )、脾囊肿 ( 9.7% )、脾结核 ( 6 .5 % )、脾局限性纤维化 ( 3 .2 % )、脾血肿( 3 .2 % )、脾淋巴组织反应性增生 ( 3 .2 % )、脾动脉瘤伴钙化 ( 3 .2 % )、脾肉芽肿样病变 ( 3 .2 % ) ;其中良性病变占 80 .6 % ,脾脏占位性病变的诊断以影像学诊断为主 ,单一影像诊断技术误诊率高 ( 4 8.4% ) ,多种影像诊断技术的联合应用很重要 ;鉴别诊断主要是癌瘤患者随诊过程中发现的原发性脾占位性病变与脾转移瘤的区别。手术是治疗脾占位性病变的主要手段 ,术后并发症发生率为9.7% ,其中以感染性并发症为主。结论 脾脏以良性占位病变多见 ,诊断采用多种影像技术的联合应用效果好 ,治疗以手术为主 。

Objective To probe of epidemiology,methods of diagnosis and treatment of primary splenic space occupying lesion.Methods Thirty one cases of primary splenic space occupying lesion admitted to our hospital in the period of 1958 to 1999 were studied retrospectively.Results The incidence of primary splenic space occupying lesion from high to low in proper order were:splenic cavernous hemangiomas(32.3%),splenic angiosarcoma(19.4%),splenic cricumscribed hyperemia(12.9%),splenic cyst(9.7%),splenic tuberculosis(6.5%),splenic cricumscribed fibrosis(3.2%),splenic hematoma( 3.2% ),splenic lymphdenosis( 3.2% ),splenic aneurysm linked calcification(3.2%),splenic granulomatous inflammation(3.2%);among them benign space occupying lesion occupied for 80.6%,non tumour ones for 45.1%.Diagnosis for splenic space occupying lesion were mainly depended on image,especially united more than one type of image,misdiagnosis rate of one type image was 83.9%.Operation was mainly therapeutic method.Postoperative complication occured in 9.7%,mainly were infectious complication(2/3).Conclusion Splenic space occupying lesions are mainly benign;united image is better for diagnosis of splenic space occupying lesion;main therpay is operation,but should be as far as possible to preserve splenic tissue and function.