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目的 探讨小儿原发性脾脏肿瘤的临床特点及其治疗。方法 回顾分析 1970年 1月～ 2 0 0 1年 12月收治的 13例小儿原发性脾脏肿瘤的临床资料。结果 13例中脾血管瘤 5例 ,脾淋巴管瘤 4例 ,脾囊肿 2例 ,脾恶性淋巴瘤 2例。良性肿瘤中行脾切除术 4例 ,部分脾切除术 7例 ;有 2例脾切除术后 1年频发呼吸道感染 ,其余恢复良好。脾恶性淋巴瘤 2例者行脾切除术 ,术后辅以化疗 ;1例术后生存 2 3个月 ,1例术后 8个月仍随访。结论 小儿原发性脾脏肿瘤术前诊断主要依靠B超和CT ;良性肿瘤术中应尽量保留部分脾脏 ,脾切除术后 2年内应观察感染的临床表现 ;恶性淋巴瘤应采用以手术为主的综合疗法 ,早发现、早治疗是提高其生存率的唯一希望。
Objective To investigate the clinical features and treatment of pediatric primary spleen tumors. Methods The clinical data of 13 children with primary spleen tumors admitted from January 1970 to December 2001 were retrospectively analyzed. Results Of 13 cases, 5 were splenic hemangiomas, 4 were splenic lymphangioma, 2 were splenic cysts and 2 were splenic malignant lymphomas. 4 cases of benign tumor were treated with splenectomy and 7 cases of partial splenectomy. There were 2 cases of recurrent respiratory tract infection one year after splenectomy, and the rest recovered well. Splenic malignant lymphoma in 2 cases underwent splenectomy, postoperative adjuvant chemotherapy; 1 case survived 23 months, 1 case was still followed up for 8 months. Conclusions The preoperative diagnosis of primary splenic tumors in children mainly depends on B-mode ultrasonography and CT. In benign tumors, some spleen should be reserved as far as possible. The clinical manifestations of infection should be observed within 2 years after splenectomy. Malignant lymphoma should be treated by surgery Comprehensive therapy, early detection, early treatment is to improve the survival rate of the only hope.