直肠类癌的临床诊断与治疗分析

Analysis on the Diagnosis and Treatment of Rectal Carcinoid

为探讨直肠类癌的临床特点、诊断、治疗及预后，回顾分析26例直肠类癌患者的临床资料，并进行随访。结果显示，26例患者中，男性多于女性；平均年龄51岁；肿瘤位于距肛缘8cm以内直肠为21例（80．8％）；主要临床表现为肛周坠胀不适（4例）、大便带血（10例）、排便习惯改变（7例）、不完全性肠梗阻（1例），无症状者健康体检时发现（4例）；诊断主要依赖于直肠指检、直肠镜检查、电子结肠镜检查及活检结果；26例均行手术治疗且经术后病理证实；术后5年生存率76．9％（20／26）。结果表明，直肠指检对发现直肠类癌有重要作用，影响直肠类癌预后的主要因素为肿瘤大小、肿瘤的浸润及转移情况；早期诊断及早期个体化的手术是治疗本病的关键。

The objective of the study was to review the clinical characteristics,the diagnosis,treatment and prognosis of rectal carcinoid. The clinical data of 26 patients with rectal carcinoid was analyzed retrospec- tively,and followed up was also made. As results,male patients was more in number in the 26 cases ~ their average age was 51 years^the distance between the rectal carcinoid and anus wasless than 8cm in 21 cases （80.8%） ;the main clinical symptoms were perianal tenesmus sensation（in 4 cases）,bloody stool （in 10 cases） , change of defecation habit （in 7 cases）, incomplete intestinal obstruction （in I case） and asymptomatic carcinoid carriers found at physical examination（in 4 cases） ;digital examination of rectum, rectoscopy,elec- tronic colonoseopy and biopsy were the main and reliable examination means;surgical treatment was con- ducted in all the 26 cases and the diagnosis was all confirmed by pathology;and the postoperative 5-year survival rate was 76. 9% （20/26）. It is suggested that digital examination is of important significance in finding rectal eareinoid; carcinoid size,infiltration and metastasis are the main factors influencing carcinoid prognosis; and early diagnosis and early individualized surgical operation are the keys in carcinoid treatment.