脾肿瘤68例诊断和治疗体会

目的：总结脾肿瘤的临床特点及诊治的经验。方法：回顾性分析收治的68例脾肿瘤患者的临床病理资料。结果：脾良性肿瘤31例（45.59%）,包括脾囊肿15例,血管瘤12例,淋巴管瘤3例,淋巴瘤11例。术前B超诊断为占位性病变者57例（83.82%）,CT诊断为占位性病变者62例（91.18%）。59例行脾切除术,6例行脾部分切除术,2例行脾囊肿穿刺引流术,1例行穿刺活检术。良性肿瘤22例获13～114个月随访,均生存良好。恶性肿瘤23例获12～79个月随访,8例淋巴瘤生存时间为14～79个月,中位生存时间33个月,其他恶性肿瘤15例,仅3例生存〉2年,其余均在3～12个月内死亡。结论：B超和CT检查是脾肿瘤的主要诊断手段,治疗上应以手术治疗为主。良性肿瘤无论行脾切除术或脾部分切除术,术后均无需特殊处理;恶性肿瘤应以手术为主,恶性淋巴瘤在脾切除术基础上行辅助化疗对延长生存期有意义,对转移癌患者尚需在术后行相应的辅助性治疗。

Splenic Tumor 68 Diagnosis and Treatments

Objective：Purpose Summary of the clinical features of splenic tumor and treatment experience.Method： Retrospective analysis of the clinicopathological data of the 68 Patients with splenic tumors.Result： 31 Splenic benign tumour（45.59%）,including 15 Spleen cyst,12 Hemangioma,3 Lymphangioma and 11 Lymphoma.57 ultrasonic scanning diagnosis is space-occupying before the operation（83.82%）.62 lesions of CT diagnosis is space-occupying（91.18%）.59 Splenectomy,6 Partial resection of the spleen,2 Splenic cyst drainage,Biopsy of 1.22 Benign received 13～114 months visit who are in good survival.23 Malignant received 12～79 months visit,8 Lymphomas survived for 14～79 months,neutral positions survived for 33 months,with a average of 33months,among 15 malignants,only 3 of them survived for over 2 years,while the rest died within 3～12 months.Conclusion：ultrasonic scanning and CT examination is the primary splenic tumor diagnostics,The treatment of surgical treatment should be based. Benign doesn＇t need Special treatment after Splenectomy or splenic partial laryngectomy;the treatment of surgical treatment should be based on the Malignant,Malignant lymphoma is meaningful for the Adjuvant chemotherapy after the Splenectomy.,Treatment of the corresponding auxiliary is necessary for the Patients with metastatic carcinoma after operation.