非寄生虫性脾囊肿3例报告及文献综合剖析.docVIP

非寄生虫性脾囊肿3例报告及文献综合剖析 　　[摘要] 目的 总结我国非寄生虫性脾囊肿(NPSC)的诊治经验。方法 报告3例及网上搜索1973～2008年间发表的NPSC文献249篇,对临床和病理资料回顾性研究。结果 ①NPSC占脾脏良性肿瘤的33.9%,真性囊肿占59.8%;②左上腹胀痛及肿块占46.6%及50.0%;③B超或CT诊断阳性率分别为90.5%和93.4%;④开腹全脾切除占74.2%;⑤儿童全脾切除未加自体脾片移植暴发性感染占6.3%。结论 NPSC较多见,真性囊肿多于假性囊肿,左上腹胀痛及肿块为主要临床表现,影像学检查阳性率高。成人开腹全脾切除仍是主要手术方式,儿童尽可能采用全脾切除加自体脾片移植或脾部份切除。 　　[关键词] 脾囊肿;非寄生虫性;病例报告;文献分析 　　[中图分类号] R657.6[文献标识码] A [文章编号] 1673-9701(2009)36-26-03 　　 　　Non-parasitic Splenic Cyst:A Report of 3 Cases and A Comprehensive Analysis of Literature 　　HE Jianjun 　　Department of General Surgery,Ningxiang People’s Hospital,Changsha 410600,China 　　 　　[Abstract] Objective To summarize the diagnosis and treatment of non-parasitic splenic cyst(NPSC) in China. Methods The retrospective analysis was made of3cases report and 249 published articles of NPSC between 1973 and 2008 in the domestic network. Results ①NPSC accounted for 33.7% of spleen benign tumors, and true cyst accounted for 59.8%. ②Epiabdominal pain and mass accounted for 46.6% and 50.0%. ③The B-Ultrasound and CT positive rates were 90.5% and 93.4%. ④The whole splenectomy accounted for 74.2%. ⑤Outbreak infection caused by whole splenectomy without autogenous spleen graft in children accounted for 6.3%. Conclusion NPSCs are common and true cysts are more than false ones,with epiabdominal pain and mass as their main cinical manifestations. The imagingexamination shows higher positive rate. The whole splenectomy is the main selection of surgical approach in adult and the whole splenectomy with autogenous spleen graft or partial resection of the spleen is the main selection of surgical approach in children as far as possible. 　　[Key Words] Spleen cyst;Non-parasitic splenic cyst;Case report;Literature analysis 　　 　　脾囊肿分为寄生虫性和非寄生虫性两大类。寄生虫性脾囊肿(parasite spleen cysts,PSC)几乎全由棘球绦虫引起。非寄生虫性脾囊肿(NPSC)根据囊肿壁有无内衬上皮,分为真性(原发性脾囊肿)和假性(继发性脾囊肿)。NPSC临床少见,但在脾脏良性肿瘤中所占比例并不低。我科自1975年以来收治3例复习文献共834例,进行临床和病理资料的回顾性研究,探讨其发病情况、临床病理特征及诊断和治疗。 　　 　　1资料与方法 　　 　　1.1病例资料 　　例1 女,43岁,左上腹胀痛2年,