原发性十二指肠肿瘤26例诊治分析

Diagnosis and treatment in 26 cases of patients with primary tumor of the duodenum

目的回顾性分析26例原发性十二指肠肿瘤的诊治情况。方法收集本院内镜室近两年来所检出的原发性十二指肠肿瘤患者26例,对其一般情况、临床症状、肿瘤发生部位及病理检查、诊治情况进行分析。结果原发性十二指肠肿瘤临床上以腹痛、黄疸多见;病变多发于十二指肠乳头周围部;良性肿瘤者病理多表现为腺瘤,而恶性肿瘤者多表现为腺癌;内镜(包括胃镜和十二指肠镜)结合十二指肠低张造影可显著提高该病的诊出率,而其他检查方法检出率不高;外科手术切除是最基本的治疗方法。结论本病的误诊率相对较高,对于40岁以上患者出现腹痛、黄疸、上消化道出血、高位肠梗阻及溃疡症状而又不能用肝、胆、胃等疾病解释时,要考虑该病的可能,从而针对本病做详细地检查,减少误诊,提高早期诊出率。

Objective To explore the diagnosis and treatment in 26 patients with primary tumor of the duodenum （PTD）. Methods Twenty-six cases of patients with PTD were collected in the division of endoscopy in our hospital in the last two years. Then an retrospective research was made on them, including the general state of health, clinical man- ifestation, position of tumor, pathological findings, treatment and so on. Results The abdominal pain and jaundice were the common syndromes of PTD. It was usually found around the duodenal papilla. Endoscope （gastroscope and duodenoscope） combined with hypotonie duodenography may enhance the detectable rate of this disease. And the surgical resection was the basic treatment. Conclusion More attention should be paid to PTD for its high misdiagnosis rate.