原发性小肠肿瘤63例临床分析

Clinical analysis of 63 patients with primary small bowel tumors

目的 :总结原发小肠肿瘤的诊断及治疗方法。方法 :回顾性分析 6 3例小肠肿瘤的临床资料。结果 :6 3例均经手术和 (或 )病理检查证实诊断 ,其中良性肿瘤 1 6例 ,恶性肿瘤 4 7例。主要表现为腹痛、腹部包块、肠梗阻及消化道出血等。术前确诊 2 2例 ,其余均误诊 ,误诊率为 6 5 .1 %。本组均行手术治疗 ,其中良性肿瘤行肿瘤及局部肠管切除 ,恶性肿瘤则行根治性切除、姑息性切除及捷径手术 4例。本组无手术死亡。恶性肿瘤 1、3、5 a生存率分别为 6 5 .8%、4 2 .1 %、2 0 .3%。结论 :小肠肿瘤缺乏特异性体征 ,术前误诊率高。对有出血、腹痛、梗阻、包块等临床表现者应怀疑本病可能 ;对诊断不明者应综合采用各种检查 ,必要时剖腹探查 ,一经诊断 。

Objective: To summarize the experience in the diagnosis and treatment of primary small bowel tumors. Methods: Clinical data of 63 patients with primary small bowel tumors were analyzed retrospectively. Their diagnoses were testified by operation, pathological examination, or the both. Results: There were 16 benign tumors and 47 malignant ones. The common clinical presentations were abdominal pain, abdominal mass, intestinal obstruction and gastrointestinal hemorrhage. Preoperative diagnoses were only made in 22 subjects, and the misdiagnosis rate was 65.1%. All patients underwent operation, and there was no operation death. The survival rates in 1, 3 and 5 years in patients with malignant tumors were 65.8%, 42.1% and 20.3%, respectively. Conclusion: The clinical manifestations in small intestinal tumors are non-specific, and there exists a higher misdiagnosis rate. It is likely to have the tumors of small intestine who has the clinical manifestations such as gastrointestinal hemorrhage, intestinal obstruction and abdominal mass. Suspected patients should receive various examinations; if possible, exploratory laparotomy should be considered. Prompt operation must be performed once the definite diagnosis is made.