成人小肠肿瘤36例临床分析

Clinical analysis of 36 cases of adult small intestinal tumor

目的探讨小肠肿瘤的临床特点及其诊断方法。方法对2000年1月至2009年1月诊治的36例小肠肿瘤的临床资料进行回顾性分析。结果36例中,良性肿瘤8例,恶性肿瘤28例。肿瘤位于十二指肠者13例,空肠11例,回肠12例。较常见临床表现为腹痛、腹部肿块、消化道出血、肠梗阻、黄疸、体重减轻等。术前诊断率为41.7%;B型超声、CT诊断符合率较低,胶囊内镜、泛影葡胺全消化道造影及数字减影血管造影(DSA)检查有助于确定病变的部位及性质。28例恶性肿瘤根治性切除率为46.4%。结论小肠肿瘤临床表现不典型,恶性肿瘤早期诊断极为困难,应加强对本病的重视和认识,以改善病人预后。

Objective To explore the clinical characteristics and diagnosis of small intestinal tumor. Methods A retrospective analysis was made on the clinical data and follow-up of 36 cases of small intestine tumors from Jan. 2000 to Jan. 2009. Results In 36 cases, there were 8 cases of benign tumors, and 28 cases of malignant tumors. Tumors located at duodenum,jejunum and ileum were found in 13 cases, 11 cases and 12 cases respectively. The most common clinical manifestations were abdominal pain,abdominal mass,gastrointestlnal hemorrhage, intestinal obstruction,jaundice,weight loss, etc. The preoperative diagnosis rate was 41.7 %. The accurate diagnostic rate by B-ultrasound, and CT scanning was lower, while capsule endoscopy, Diatrizoate contrast of the whole digestive tract, and DSA was helpful to determine the portion and quality of the lesions. In the 28 patients with malignant tumors,the radical resection rate was 46. 4 %. Conclusion Clinical manifestations of small intestinal tumors is atypical and early diagnosis for malignancy is quite difficult.