30例原发性小肠肿瘤的临床分析

Clinical Analysis of Primary Small Intestinal Tumor in 30 Cases

目的:探讨原发性小肠肿瘤的临床特点及诊断方法。方法:(1)收集本院1998年1月至2003年1 月间治疗的30例原发性小肠肿瘤(不包括十二指肠肿瘤)的临床资料进行回顾性分析。(2)通过小肠气钡对 比双重造影、腹部CT、选择性肠系膜上动脉造影及B超等检查方法的对比。(3)结合手术病理证实。结果:临 床表现有:腹痛19例,消化道出血9例,腹部包块7例,肠梗阻3例,贫血2例,消瘦2例。临床诊断为:空肠肿 瘤18例,回肠肿瘤11例,空、回肠同时发生的1例。平滑肌肉瘤16例,腺癌3例,间质瘤3例,黏膜相关恶性淋 巴瘤3例,类癌2例,鳞癌1例,平滑肌瘤1例,恶性黑色素瘤1例。结论:小肠气钡对比双重造影是目前小肠肿 瘤最有价值的诊断方法。对诊断困难的消化道出血,选择性肠系膜上动脉造影可作为常规检查方法。CT对诊 断小肠肿瘤有一定的帮助,B超诊断率低。

Objective:To analyze the clinical characteristics and diagnosis of the primary small intestinal tumor. Methods: (1) The clinical data was collected from 30 patients with primary small intestinal tumor and retrospective analysis was made.(2)Small intestine double contrast radiography, abdomen CT,selective superior mesenteric artery radiography and abdomen B ultrasound were compared. (3)The data were confirmed by surgical pathology. Result:The clinical manifestations were stomachache in 19 cases,gastrointestinal hemorrhage in 9 cases,abdomen mass in 7cases,intestinal obstruction in 3 cases,anemia in 2 cases and weight loss in 2 cases.There were 18 jejunal tumor, 11 ileal tumor and 1 jejunoileal tumor by clinical diagnosis. And 16 leiomyosarcomas, 3 adenocarcinomas, 3 interstitialomas, 3 mucosa-associated malignant lymphomas, 2 carcinoids, 1 squamous carcinoma, 1 leiomyoma and 1 malignant melanoma were diagnosed by pathology. Conclusion: Small intestine double contrast radiography was the best diagnosis method to primary small intestinal tumor at present.And the selective superior meserteric angiography can be a routine diagnosis method to unkown gastrointestinal bleeding. CT may help to diagnose small intestinal tumor. But the diagnosis rate of B ultrasound was low.