原发性小肠肿瘤的诊断与治疗

Diagnosis and treatment of primary small intestine tumors (a report of 37 cases)

目的 提高原发性小肠肿瘤的诊治水平及疗效。方法 回顾性分析1983年3月～2000年5月我院收治经手术病理证实的原发性小肠肿瘤37例及随访资料。24例恶性肿瘤12例行根治性切除,6例行姑息性切除,4例行转流术,2例行单纯剖腹探查术;13例良性肿瘤5例行肿瘤局部切除,8例行肿瘤肠段切除。随访经X线消化道气钡双重造影或十二指肠内窥镜复查32例。结果 生存时间根治性切除为14～71个月;姑息性切除14～17个月;转流术6～13个月;单纯探查2～5个月。良性肿瘤切除5～17年均健在。结论 仔细询问病史,X线气钡双重造影及十二指肠内窥镜是诊断该病的主要方法,与B超、CT或选择性血管造影等检查相结合,可提高术前诊断率。手术切除是最有效的治疗方法。

Objective To investigate the diagnosis and therapy of primary small intestine tumors and improve its treatment. Methods We summarized and analyzed the treatment methods of the 37 patients of primary small intestine tumors that had been proved by pathology in our hospital from March 1983 to May 2000, and most patients were follow - up. Among the 24 patients with malignant neoplasma, radical resection was performed in 12 patients, palliative resection in 6, crossover bypass operation in 4, only laparotomy in 2; Among the 13 patients with benign tumor, local resection was performed in 5, tumors intestine resection in 8. 32 patients were followed- up, and reexamined by radiography with gas in alimentary tract and barium meal or by duodenoscopy. Results The shortest alive time of the patients with radical resection is 1 year and 2 months, the longest in 5 years and 11 months; the alive time of the patients with palliative resection is 14 to 17 months and the patients with corssover bypass operation is 6 to 13 months, only laparotomy is 2 to 5 months. 5 to 17 years after operation, the patients with benign tumor are still alive. Conclusions Carefully inquiry of the case history, radiography with gas in the whole alimentary tract, barium meal and the usage of duodenoscopy are the main methods of diagnosis, at the same time, examine combined with Bus,CT or radiography of abdominal cavity arterial may raise the rate of diagnosis before operation. Operative resection is the most effective method.