摘要
目的探讨脾肿瘤的临床特点、诊断方法和治疗经验。方法回顾性分析34年间56例经手术治疗并病理证实的脾肿瘤患者的临床资料。结果良性39例,其中确诊为脾囊肿25例,血管瘤9例,错构瘤3例,血管淋巴管瘤1例,炎性假瘤1例,其中4例脾囊肿、1例脾血管瘤和1例脾错构瘤行脾部分切除术,其余均行脾切除术;除5例失访外预后均良好。原发性恶性肿瘤12例,其中淋巴瘤2例,血管肉瘤2例,网织细胞肉瘤2例,恶性纤维组织细胞瘤2例,平滑肌肉瘤1例,恶性神经鞘瘤1例,肌纤维母细胞瘤1例,未分型1例;其中1例行坏死感染引流术,1例行脾胰体尾联合切除,其余均行脾切除或加脾门淋巴结清扫术;获随访者8例中生存5年以上者3例,3年存活1例,4例手术后1年内死亡。脾脏转移癌5例,行脾切除或联合脏器切除术。结论影像学检查是诊断脾肿瘤的主要方法。脾良性肿瘤主张行脾部分切除术。脾恶性肿瘤应采用以手术为主的综合治疗。
Objective To study the clinical characteristics and the diagnosis and treatment of splenic tumors, Methods The clinical data of 56 cases of splenic tumors which diagnosis were confirmed by surgery and pathology were analyzed retrospectively. Results Primary benign masses were found in 39 patients including splenic cyst in 25 patients, hemangioma in 9, hamartoma in 3, lymphangioma in 1, inflammatory pseudotumor in 1. Of the 39 patients with bengin tumors, 4 cases of splenic cyst, 1 hemangioma and 1 hamartoma underwent partial splenectomy ; other underwent splenectomy ; the results of the bengin tumors were successful except 5 cases were loss of follow up. Of 12 patients with primary malignant tumors including primary splenic lymphoma in 2, angiosarcoma in 2, reticulum cell sarcoma in 2, malignant fibrous histiocytoma in 2, leiomyosarcoma in 1 , malignant neurinoma in 1 , myofibroblastoma in 1 , and unknown type in I ; of them, 1 underwent necrostic infective tissue debridement and drinage, 1 underwent splenectomy with partial pancreatectomy, other subjected to splenctomy with clearance of lymph nodes; among the followed up 8 cases, 3 survived for 〉 5 years, 1 for 3 years, 4 for less than 1 year. In addition, metastatic tumors to the spleen were found in 5 patients, splenectomy with or without combined resection of other organs was performed in all 5 patients. Conclusions Imaging examination is the main method of diagnosis for splenic tumors. Partial splenectomy is recommended for benign tumors, For malignant splenic tumors, surgery, as the main aspect of combined therapy, is required.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第8期599-601,共3页
China Journal of General Surgery
