脾脏占位性病变29例的临床分析

目的探讨脾脏占位性病变临床诊断和治疗。方法回顾分析1996年1月至2006年12月浙江金华中心医院肝胆外科手术治疗29例脾脏占位的临床资料。结果29例病人中良性19例，恶性10例。19例良性肿瘤中15例行脾切除术1例行脾部分切除术，3例腹腔镜下脾囊肿开窗术。10例恶性肿瘤中8例行脾切除术，1例累及肝左外叶及胃，同时行胃部分切除和肝左外叶切除术。1例脾血管肉瘤因肿瘤巨大并与周围脏器粘连严重，且肝脏有转移结节，无法切除而取活检。结论脾脏占位术前定位诊断较容易，定性较为困难。脾良性肿瘤可根据情况行脾切除或脾部分切除术，恶性肿瘤应采用以手术为主的综合治疗。

DIAGNOSIS AND TREATMENT OF 29 CASES WITH SPLENIC MASSES

Objective To discuss clinical characteristics and treatment of splenic masses.Methods Twenty-nine patients with splenic occupying lesions from January 1996 to December 2006 in Jinhua Municipal Central Hospital were analyzed retrospectively.Results There were 19 cases with benign and 10 cases with malignant tumors.Among the 19 cases with benign tumors,15 cases were treated with splenectomy,1 cases with partial splemectomy and 3 cases with laparoscopic unroofing of the cyst wall.Among the 10 patients with malignant tumor,8 patients were treated with splenectomy.Conclusion Preoperative localization of the lesion could be easily achieved for splenic masses,but the accurate diagnosis is not so easy.Splenectomy or partial splenectomy can be used for splenic benign tumors.Splenic malignant tumor requires adjuvant therapy after operation.