摘要
目的总结小儿脾脏良性肿瘤的临床特点及其治疗方法。方法回顾分析我院自2012年1月至2017年6月共收治4例脾脏良性肿瘤患儿的临床资料,结合相关文献进行探讨。结果 4例患儿中脾脏囊肿3例(其中表皮囊肿1例,单纯囊肿伴囊内出血1例,假性囊肿伴感染1例),脾脏血管瘤1例。所有患儿均行脾部分切除术,其中3例接受开腹手术,1例接受腹腔镜手术。围手术期无死亡病例,术后恢复顺利,无术后并发症出现。全组患儿平均随访(12.0±8.2)个月。术后均出现血小板增多症,口服阿司匹林4~6个月后停药。术后无脾脏肿瘤复发、血管栓塞、脾切除术后凶险性感染发生。结论小儿脾脏良性肿瘤早期无典型临床表现,其诊断主要依靠影像学检查,结合B超和CT检查其诊断符合率接近100%。脾脏良性肿瘤的治疗以手术为主,考虑到脾脏是小儿免疫系统的重要器官,对较小病变可行脾部分切除术。如术中难以辨别肿瘤良、恶性,需行脾切除术。
Objective Summarizing the clinical characteristics and treatment of the splenic benign tumor in children. Methods The clinical data of 4 children with splenic benign tumor in Anqing Hospital Affiliated to Anhui Medical University from January 2012 to June 2017 were reviewed. Their clinical manifestations, pathological types, diagnosis and treatment were analyzed. Results Splenic non-parasitic cysts accounted for 3 cases among all patients, including 1 case of epidermoid cyst, 1 case of simple cysts with intracapsular hemorrhage, 1 case of pseudocyst with infection and 1 case of splenic hemangioma. The ages of the children patients ranged from 9 to 13 years for an average of （ 11.8 ± 1.9） years. All of them underwent partial splenectomy, in which 3 cases were treated by laparotomy procedure and 1 case was treated with laparoscopic procedure. There were no deaths in the perioperative period and all of them were recovered after operation. There were no complications such as intraperitoneal hemorrhage, abscess under the diaphragm, pancreatic fistula and embolization. All patients were followed up for an average of （12 ± 8.2） months. Among them, the shortest follow-up was 6 months and the longest was ：2 years. All patients occurred thrombocytosis after the operation and were treated with Aspirin Tablets for 4 to 6 months. The results of follow-up showed no recurrence of splenic tumor, vascular embolism and overhelming postsplenectomy infection. Conclusion There is no typical clinical manifestation of splenic benign tumor in children at early stage. It is mainly diagnosed by imaging examination. The diagnostic accuracy rate with ultrasound and CT examination was close to 100%. The treatment of the splenic benign tumors is surgical operation. Considering the spleen is an important organ of the immune system in children, the treatment of splenic benign tumors with small lesions is partial splenectomy. If the tumor is difficult to distinguish between benign and malignant tumors during operation, splenectomy is required.
作者
黄珊
徐冰
胡耀宗
蔡宝
张发明
田甲
吴凡
袁幸
HUANG Shan;XU Bing;HU Yao-zong(Department of Pediatric Surgery,Anqing Hospital Affiliated to Anhui Medical University,Anqing 246003, Chin)
出处
《肝胆外科杂志》
2018年第2期126-129,共4页
Journal of Hepatobiliary Surgery
关键词
脾肿瘤
脾切除术
小儿
splenic neoplasms
splenectomy
children
