32例脾脏肿瘤临床病理及预后分析

目的:总结临床病例，探讨脾脏肿瘤的临床诊疗经验。方法:对2002年1月至2012年2月期间收治的32例脾脏肿瘤患者的临床表现、影像学特点、治疗方法和远期生存进行分析。结果:32例脾脏肿瘤均行脾切除术（包括开腹和腹腔镜手术），均经术后病理证实。良、恶性肿瘤各占50%。脾脏最多见的恶性肿瘤为淋巴瘤（25.00%）、血管肉瘤(15.63%)；最多见的良性肿瘤前三位为脾囊肿(18.75%)、血管瘤(15.63%)、淋巴管瘤(12.50%)。临床表现无特异性。CT影像学特点为脾脏均匀增大，或脾实质内单发或多发结节。16例恶性肿瘤的中位生存时间为16个月（95%CI:6.28~25.72）。结论:病史和影像学检查是诊断脾脏肿瘤的重要依据。良性肿瘤手术效果佳，根治手术和综合治疗是改善脾脏恶性肿瘤预后的重要措施。

Diagnosis and treatment of 32 patients with splenic tumors

Objective:To summarize the experience on diagnosis and treatment of splenic tumors.Methods:The clinical manifestations,image characteristics,treatment and prognosis of 32 splenic tumor patients treated in our hospi-tal from January 2002 to February 2012 were analysed.Results:All patients underwent splenectomy confirmed by pa-thology.The benign and malignant tumors occupied one half.The most common malignant tumors were lymphoma (25.00%)and hemangiosarcoma(15.63%).Top three benign tumors were cyst(18.75%),hemangioma(15.63%) and lymphangioma(12.50%).The symptoms and signs were non -specific.CT scan showed that the spleens were en-larged uniformly or had solitary/multiple space -occupying lesions in the parenchyma.The median survival time of malignant tumors was 16 months(95%CI:6.28 ~25.72).Conclusion:Clinical history and imaging examination are important in the diagnosis of splenic tumors.The effect of surgery in treatment of splenic benign tumors is satisfactory. For malignant tumors,comprehensive treatment is important for improving survival.