小儿原发性脾脏肿瘤13例临床分析

The clinical analysis of 13 children with primary splenic tumor

目的 探讨小儿原发性脾脏肿瘤的临床特点及其治疗。方法 回顾分析 1970年 1月～ 2 0 0 1年 12月收治的 13例小儿原发性脾脏肿瘤的临床资料。结果 13例中脾血管瘤 5例 ,脾淋巴管瘤 4例 ,脾囊肿 2例 ,脾恶性淋巴瘤 2例。良性肿瘤中行脾切除术 4例 ,部分脾切除术 7例 ;有 2例脾切除术后 1年频发呼吸道感染 ,其余恢复良好。脾恶性淋巴瘤 2例者行脾切除术 ,术后辅以化疗 ;1例术后生存 2 3个月 ,1例术后 8个月仍随访。结论 小儿原发性脾脏肿瘤术前诊断主要依靠B超和CT ;良性肿瘤术中应尽量保留部分脾脏 ,脾切除术后 2年内应观察感染的临床表现 ;恶性淋巴瘤应采用以手术为主的综合疗法 ,早发现、早治疗是提高其生存率的唯一希望。

Objective To discuss the clinical characteristics and treatment of children with primary splenic tumor.Method A retrospective analysis was made on 13 children with primary splenic tumor from January 1970 to December 2001.Results There were splenic hemangioma in 5,splenic lymphoma in 4,splenic cysts in 2 and splenic malignant lymphoma in 2.In the primary splenic benign tumors,4 cases were treated with splenectomy,7 cases were treated with partily splenectomy;2 cases of splenectomy often had respiratory tract infection 1 year postoperatively.2 of the splenic malignant lymphoma were treated with splenectomy and chemotheraphy postoperatively;1 of them died 23 months postoperatively,another is still alive 8 months postoperatively.Conclusions The diagnosis of primary splenic tumor in children is mainly depended on B-ultrasound examination and CT scanning.Children with primary splenic benign tumors should be retained normal spleen as far as possible intraoperatively.It is important for splenectomy to pay more attention to the clinical infection 2 years postoperatively.Splenectomy combined with chemotherapy may provide optimum therapy for children with primary splenic malignant lymphoma.Early detection and treatment are crucial to increase the survival rate of children with primary splenic malignant lymphoma.