原发性脾脏肿瘤的临床诊治总结  

Clinical diagnosis and treatment of primary splenic tumor

作　　者：杨毅军[1] 石景森[1] 王健生[1] 赵凤林[1] 何平[1] 孙立江[1] 朱爱军[1] 

机构地区：[1]西安交通大学第一医院肝胆外科研究室,西安市710061

出　　处：《中华肝胆外科杂志》2002年第1期34-36,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　总结原发性脾脏肿瘤的临床诊治的经验 ,以利提高脾脏肿瘤的疗效。方法　回顾性分析我院收治的 31例脾脏原发肿瘤病人的临床资料。结果　 31例中有 2 5例术前诊断为脾脏占位病变。良性肿瘤 19例中 14例行脾切除 ,5例行肿瘤切除或脾部分切除 ;恶性肿瘤 12例中 11例行脾切除 (其中 2例加胰体尾切除 ) ,1例活检。术后病检结果 :良性肿瘤中各类囊肿 11例 ,海绵状血管瘤 4例 ,炎性假瘤 2例 ,平滑肌瘤囊性变和海绵状淋巴管瘤各 1例 ;恶性肿瘤中恶性淋巴瘤和淋巴肉瘤 6例 ,血管肉瘤 3例 ,纤维肉瘤、平滑肌肉瘤和恶性纤维组织细胞瘤各 1例。恶性肿瘤中术后生存 5年以上 3例 ,均为早期且联用放疗或化疗、免疫治疗。结论　脾脏肿瘤的诊断主要靠临床表现及影像学检查 ,良恶性鉴别可根据CT、血管造影和血清AKP、γ GT。早期诊断、根治手术和综合治疗是改善脾脏恶性肿瘤预后的重要手段。Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN). Methods The clinical data of 31 patients with PSN treated in our hospital were retrospectively analyzed. Results Amongst the patients, 25 were diagnosed as PSN postoperatively. Fifteen out of the 19 patients with benignancy were treated with splenectomy, and the others underwent partial splenectomy or tumor excision. Eleven out of the 12 patients with malignancy received splenectomy (including two by excision of pancreatic body and tail), and the other one underwent biopsy alone. The pathological types were as follows: varieties of cyst in 11, angiocavemoma in 4, inflammatory pseudotumor in 2, cavernous lymphangioma in 1, cystic degeratin of liomyoma in 1, malignant lymphoma and lymphsarcoma in 6, hemangiosarcoma in 3, fibrosarcoma in 1, liomyosarcoma in 1 and malignant fibrous histiocytoma in 1. Three patients with malignancy survived for 5 years. The reason was that they received radical splenectomy in combination with chemotherapy or radiotherapy and immunotherapy. Conclusions PSN should be diagnosed mainly according to clinical manifestations and image examination. The differentiation between benignancy and malignancy depends on CT, hemangiography and determination of seros AKP and γ GT levels. Early diagnosis, radical operation and comprehensive treatment are important for improving the prognosis of PSN.

关 键 词：脾肿瘤 诊断 治疗 原发性脾脏肿瘤 根治手术 综合疗法 

分 类 号：R733.2[医药卫生—肿瘤]