原发性脾脏肿瘤23例的诊断与治疗

目的 探讨原发性脾脏肿瘤的诊断和治疗。方法 回顾性分析23例原发性脾脏肿瘤患者的临床资料。结果 23例原发性脾脏肿瘤临床表现无特异性。B超检查均首先发现脾脏肿块，14例再行CT检查，8例行彩色多普勒超声检查，其中11例综合诊断为脾脏囊肿，8例术后病理证实；10例综合诊断为脾脏恶性肿瘤，8例术后病理证实。全组中20例行手术治疗，采用不同手术方式，无手术并发症。脾脏良性肿瘤预后佳，8例脾脏恶性肿瘤仅2例存活至今。结论 原发性脾脏肿瘤的诊断主要为B超和CT等影像学检查；良性肿瘤尽量保脾，恶性肿瘤行根治性脾切除术及术后放化疗和免疫治疗等。

Clinical diagnosis and treatment of 23 cases with primary splenic tumor

Objective To explore the diagnosis and treatment of primary splenic tumor. Methods The clinic data of 23 patients with primary splenic tumor were retrospectively analyzed. Results The symptoms and signs of 23 patients were non-specific. Imaging diagnosis resorted to B-ultrasonograpy and CT. B-ultrasonography first diagnosed splenic mass in all patients and then 14 patients were examined by CT and 8 by color Doppler. Among them 11 patients were diagnosed with splenic cysts, 8 of whom confirmed by pathology and 10 patients diagnosed with splenic malignant tumor, 8 of whom confirmed by pathology. There were 20 patients operated by different methods, with no complication. The prognosis of benign splenic tumor was better but only 2 of 8 splenic malignant tumor patients survived. Conclusion Primary splenic tumor should be diagnosed mainly by B-ultrasonography and CT. Saving-spleen operation is recommended for benign splenic tumor, and radical operation and postoperative radiochemotherapy and immunotherapy are important for splenic malignant tumor.