原发性小肠肿瘤58例临床分析

Clinical analysis of 58 cases of primary small bowel tumor

目的分析原发性小肠肿瘤的临床病理特征及诊断方法。方法回顾性分析经病理证实的58例原发性小肠肿瘤的临床资料。结果恶性45例,以腺癌、平滑肌肉瘤、恶性淋巴瘤为主。良性13例,以平滑肌瘤、血管瘤、腺瘤为主。主要临床表现为腹痛、出血、贫血、腹块、黄疸、消瘦、肠梗阻等。术前确诊率为15.52%(9/58),易误诊为其他消化系统疾病及盆腔疾病。结论原发性小肠肿瘤以恶性多见。临床表现缺乏特异性,检查手段相对不足,诊断较困难,临床医生应提高对小肠肿瘤的认识。DSA,胃肠X线、内镜及B超、CT等检查有一定诊断价值。

Objective To investigate the clinical manifestations, histopathological patterns and the methods of diagnosis of primary small bowel tumor （PSBT）. Methods The clinical data of 58 cases of PSBT confirmed by pathology admitted from 1978 to 2004 in our hospital were retrospectively analyzed. Results The main pathological patterns were adenocarcinoma, leiomyosarcoma. lymphoma and malignant neurilemmoma in 45 malignant PSBT and leiomyoma, angioma, adenoma, and neurilemmoma in 13 benign PSBT. The common clinical manifestations were abdominal pain. anemia and hemorrhage, mass. jaundice, weight loss and intestinal obstructions. Preoperative diagnosis rate was 15.32%（9/58）. h was easily misdiagnosed as other digestive tract diseases and pelvic disorders. Conclusion The main pathological pattern of PSBT is malignant, the clinic manifestations were absent from specificity and diagnostic examination methods are relative shortage, which make it difficuh to diagnose. It must be paid attention to small bowel tumors by clinicians. Angiography. intestinal tract X-ray. endoscopy, ultrasound and CT are helpful for diagnosis of PSBT.