原发性小肠肿瘤的诊治

Diagnosis and Treatment of Primary Small Bowel Tumor

目的 探讨原发性小肠肿瘤的临床特点及其诊断和治疗。方法 1990年以来诊治的 3 9例原发性小肠肿瘤的临床资料及随访结果进行回顾性分析。结果 3 9例中 ,良性肿瘤 8例 ,恶性肿瘤 3 1例 ;肿瘤位于 12指肠 10例 ,空肠 13例 ,回肠 16例。最常见的临床表现为腹痛、腹块、消化道出血、肠梗阻、黄疸等。 3 9例均经手术治疗 ,术前诊断率为 48 7% ( 19/3 9) ,3 1例恶性肿瘤根治性切除率为 2 2 6% ( 7/3 1) ,其中 2 3例获得随访 ,死亡 16例 ,目前存活 7例。B超、CT诊断符合率较低 ,DSA检查有助于确定病变的部位及性质。结论 原发性小肠肿瘤临床表现不典型、恶性肿瘤早期诊断极为困难 ,改善病人预后的关键是加强对本病的重视和认识。

Objective To explore the clinical characteristics, diagnosis and treatment of primary small intestinal tumors. Methods The clinical and follow-up data of 39 cases of primary small intestinal tumor received treatment in our hospital since 1990 were retrospectively analyzed. Results In this group of patients, 8 cases were benign tumors while the other 31 cases were maliganat. Tumors located at duodenum, jejunum and ileum had 10, 13 and 16 cases, respectively. The most common clinical manifestations were abdominal pain, abdominal mass, gastrointestinal haemorrhage and jaundice, etc. All the 39 cases underwent operation, and the preoperative diagnostic rate was 48.7%(19/39). In the 31 cases of malignant tumors, the radical resection rate was 22.6%(7/31), and 23 cases were followed up, of which 16 cases died, and the other 7 cases survived. The accurate diagnostic rate of B-ultrasound/CT scanning was lower, while digital subtract angiography was helpful to make sure the position and quality of the lesions. Conclusion The clinical manifestation of primary small intestinal tumor was atypical and early diagnosis for malignancy was quite difficult, so intensive study and recognization of this lesion should be emphasized to improve the prognosis of the patients.