脾脏占位性病变的诊治体会

Diagnosis and Treatments of the Splenic Space-Occupied Lesions

目的 总结脾脏占位性病变诊治的经验 ,以期提高诊治水平。方法 对 40例脾占位病变病例诊治经过结合相关文献进行回顾性分析。结果 40例病例中 ,37例经手术及病理证实 ,3例影像学证实脾脏占位。 37例中 ,良性 2 4例 (6 5 %) ,恶性 13例 (35 %) ,术前确诊率 6 4.8%(2 4/37)。 2 8例行开腹单纯脾切除术 ,10例行原发病灶根治术 +脾切除术 ,1例行腹腔镜脾切除术 ,均痊愈出院。结论 除临床症状、体征外 ,B型超声、CT等影像学检查是定位、定性诊断的重要手段。本病应早手术 ,手术仍以脾切除为主。

Objective To improve the diagnosis and treatment of the splenic space-occupied lesions. Methods Diagnosis and treatment of 40 cases of the splenic space-occupied lesions were retrospectively reviewed in combined with some related literatures. Results Of the 40 cases, 37 cases were confirmed the diagnosis by operations and histological examinations, and the remaining 3 cases were proved by imaging examinations. Among the 37 cases, 24 cases (65%) were benign and 14 cases (35%) were malignant. The preoperative diagnostic rate was 64.8%(24/37). Laparotomy and splenectomy were performed in 28 cases, dissection of the original neoplasm plus splenectomy in 10 splenic metastasis cases and splenectomy by laparoscopy in 1 case. All the cases were cured and discharged. Conclusions Besides the clinic symptoms and signs, CT and B-US are also important methods for location and identification of the lesions. The splenic neoplasm should undergo early operation and the surgical management is mainly splenectomy.