小肠平滑肌肉瘤急诊诊治临床研究

LEIOMYOSARCOMA OF THE SMALL INTESTINE:REALIZATION OF EMERGENT DIAGNOSIS AND TREATMENT

目的 :探讨小肠平滑肌肉瘤这一不常见疾病的诊治规律。方法 :对比研究本组 12例小肠平滑肌肉瘤的术前、术中及术后诊断 ,剖析小肠平滑肌肉瘤的临床特点 ,比较其与急诊处理腹部外科常见疾病的异同。结果 :急诊术前误诊率为 10 0 % ,急诊术中误诊率为 5 0 % ,术中选择手术方式的合格率占 6 6 .7%。急诊未能行根治术者 5 0 %近期复发。结论 :小肠平滑肌肉瘤的特点是术前相当难以明确诊断 ,提高对小肠平滑肌肉瘤的术中认识及诊断水平 ,选择合理的手术方式 ,同时坚持根治原则及无瘤操作的原则 ,以确保治疗效果。

Objective:to inquire into the law of diagnosis and treatment of rare disease:leiomyosarcoma of the small intestine.Methods:We contrasted the preoperative and the operative diagnoses,respectively,with the postoperative ones of these 12 leiomyosarcomas of the small intestine,analysed the clinic characteristics of leiomyosarcoma of the small intestine and compared the distinctions of emergent diagnosis and treatment of these patients with other usual diseases of general surgery.Results:The error rates of emergent preoperative and operative diagnoses were 100% and 50%,respectively.Only 66.7% emergent operative procedures were up to standard.And there were 50% patients with recent recurrences after emergent palliative operations.Conclusions:It is rarely hard to correctly diagnose the leiomyosarcoma of the small intestine preoperatively.We must raise the level of the operative judgement and diagnosis,then choose rational operative procedure and simultaneously stick to the principles of radical and en bloc resections in order to gain better therapeutic effects.