朱文祥　吴向华　覃雅

[摘要] 目的 探讨脾肿瘤的临床特点及预后。 方法 回顾性分析广西医科大学第一附属医院2003年1月～2017年6月脾肿瘤患者64例的临床资料并随访，对脾肿瘤临床特点、诊断、治疗、预后进行分析。 结果 脾肿瘤患者共64例，其中良性脾肿瘤53例，恶性脾肿瘤11例。恶性中包括原发性恶性脾肿瘤8例、转移性脾肿瘤3例。良性脾肿瘤行脾切除术，恶性脾肿瘤行手术加辅助放化疗。良性脾肿瘤随访者35例，33例生存良好。原发性恶性脾肿瘤随访4例，最长2017年12月已存活7年，治疗方式为脾切除加辅助化疗。转移性脾恶性肿瘤随访1例，术后存活2年。 结论 脾肿瘤发病率较低，病理类型多樣，B超、CT是重要的影像学检查手段。治疗以手术为主，良性脾肿瘤预后可，恶性预后不佳。早期诊断、根治手术及辅助化疗的综合治疗是改善原发性脾脏恶性肿瘤预后的重要手段。

[关键词] 脾肿瘤；临床特点；外科治疗；预后

[中图分类号] R733.2 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0096-04

[Abstract] Objective To analyse the clinical characteristics and prognosis of splenic tumor. Methods From January 2003 to June 2017， in the First Affiliated Hospital of Guangxi Medical University， the clinical data of 64 patients diagnosed splenic tumor were etrospectively analyzed and followed-up， the clinical characteristics， diagnose， therapy and prognosis were analyzed. Results Among 64 splenic tumors cases， 53 cases were benign tumors and 11 cases were malignant tumors. Malignant tumors contained 8 primary splenictumors cases and 3 metastatic splenic tumors cases. The benign tumors were given splenectomy， and malignant tumors were given splenectomy combined with adjuvant radiotherapy and chemotherapy. Thirty-five cases benign tumors were followed up， 33 cases had a good recovery. Four cases with primary malignant tumors were followed up， the longest follow-up case treated with splenectomy and chemotherapy had been alive 7 years until December 2017. One case with splenic metastatic tumors were followed up， the patient had been alive 2 years after surgery. Conclusion The splenic tumor has a low incidence， pathology is complex， CT and B-mode ultrasound are important imaging measures to diagnose splenic tumor. The benign splenic tumors have a better prognosis， but malignant ones have a poor prognosis. The main treatment for splenic tumor is surgery. Earlier diagnosed， radical operation and chemotherapy are important measures for primary splenic malignant tumors.

[Key words] Splenic tumor； Clinical characteristics； Surgical treatment； Prognosis

脾肿瘤（splenic tumors）在临床上较少见，国外文献报告脾肿瘤发病率低于1%[1]。检索国内相关数据库发现，有关脾肿瘤报道不多，但关于脾肿瘤的治疗，存在不同意见。本研究回顾性分析广西医科大学第一附属医院（以下简称“我院”）脾肿瘤患者的临床资料，对该组脾肿瘤临床特点、诊断治疗、预后进行讨论。

1 资料与方法

1.1 一般资料

选择2003年1月～2017年6月我院确诊为脾肿瘤患者共64例，所有患者经病理证实。其中男31例，女33例；年龄14～76岁，平均（42.90±16.59岁）；≤44岁33例（51.56%），>44～60岁22例（34.37%），>60岁9例（14.07%）。

1.2 方法

回顾性分析64例脾肿瘤患者的临床资料，对脾肿瘤临床特点、诊断、治疗、预后进行分析。……