原发性小肠肿瘤24例诊疗体会

Diagnosis and treatment of 24 cases of primary tumors of small intestine

[目的]探讨原发性小肠肿瘤临床特点、诊断与治疗方法。[方法]回顾性分析2004年8月-2009年8月大连医科大学附属第二医院普外科经手术和病理证实的24例原发性小肠肿瘤的临床资料，从肿瘤的发病部位、病理、临床表现、诊断及治疗五方面进行分析。[结果]原发性小肠肿瘤中常见的临床表现有腹痛（8例）、腹部包块（4例）、消化道出血（11例）、肠梗阻（5例）、黄疸（3例）、无症状（2例）；另外，血常规提示消瘦贫血（18例）；术前确诊仅8例；术中证实肿瘤位于十二指肠5例，空肠7例，回肠11例，空回肠多发1例；其中，恶性15例，良性肿瘤9例。[结论]原发性小肠肿瘤的临床表现缺乏特异性，多数患者术前确诊困难，手术切除是主要的治疗手段。

[ Objective] To explore the clinical characteristics ,diagnosis and treatment of primary tumors of small intestine. [ Methods] Twenty-four cases of primary tumors of small bowel were collected from 2004 to 2009 in our hospital, which were confirmed by operation and pathological test. The location of tumor,pathological character,clinical manifestation ,diag- nosis and treatment were analyzed. [ Results ] The features of the small intestinal tumor could be abdominal pain （8 cases）, abdominal mass （4 cases）,hemorrhage （11 cases）,obstruction （5 cases）,jaundice （3 cases） and symptomless （2 cases）. Blood test shown emaciation and anemic （ 18 cases）. Only 8 cases were diagnosed pre - operatively. Tumor location was at the duodenum （5 cases） ,the jejunum （7 cases） ,the ileum （11 cases） and both jejunum and ileum （1 case）. Benign tumors were seen in 9 cases and malignant ones were in 15 of them. [ Conclusion] The clinical manifestations of primary tumors of small intestine are not specificity. It is difficult to make a diagnosis before the operation. Surgical treatment is the principal therapy for the primary malignant bowel tumor.