原发性小肠肿瘤112例临床分析

Clinical analysis on primary small intestinal tumor

目的探讨原发性小肠肿瘤的临床特点及诊断方法。方法回顾性分析 1 1 2例原发性小肠肿瘤的临床资料、病理特征及术前诊断方法。结果小肠肿瘤多位于十二指肠 ,占 62 5 %(70 / 1 1 2 ) ,良性肿瘤以平滑肌瘤为主 ,多位于回肠、空肠 ,恶性肿瘤以腺癌最常见 ,其次为恶性淋巴瘤 ,平滑肌肉瘤。首选的检查方法为X线钡餐 ,尤其是低张小肠灌肠造影 ,内镜检查可提高十二指肠肿瘤的诊断率 ,对诊断困难的消化道出血可行选择性肠系膜上动脉造影 ,CT对判断肿瘤的良恶性、术前分期及术后有无复发有独特的意义。结论十二指肠腺癌是最常见的原发性小肠肿瘤 ,其次为恶性淋巴瘤、平滑肌瘤及平滑肌肉瘤。低张小肠灌肠造影是诊断和定位最为有效的方法 ,CT、内镜及肠系膜上动脉造影有助于诊断。

ObjectiveTo explore the clinical characteristics and diagnosis of primary small intestinal tumor (PSIT). MethodsRetrospective analysis of the clinical and pathological data of the 112 PSIT cases was made. ResultsDuodenum was the most common site for PSIT (62 5%). Leiomyomas were most common benign tumors which were most likely found in ileum and jejunum. Adenocarcinoma was the most frequently seen malignant PSIT followed by lymphoma and leiomyosacroma. The chief method of diagnosis is barium meal X ray examination especially with the hypotonic contrast X ray examination. Endoscopy can increase the diagnostic rate. Superior mesenteric arteriography sometimes helps in determing the site of gastrointestinal haemorrhage. CT scan can be helpful in establishing diagnosis, preoperative classification and postoperative recurrences. Conclusion Duodenal adenocarcinoma is most common PSIT, followed by malignant lymphoma, liomyoma and leiomyosarcoma. Hypotonic contrast X ray examination is most effective in diagnosis, and locating of small bowel tumors. Superior mesenteric artery angiography and CT scanning are also helpful.