原发性小肠肿瘤临床诊治分析

Analysis of diagnosis and treatment of primary small intestinal tumors

目的探讨原发性小肠肿瘤的诊治方法,以提高其治疗效果。方法回顾性分析本地区两家二级医院2004年1月至2014年1月的原发性小肠肿瘤的临床资料,分析其诊断及治疗。结果共23例原发性小肠肿瘤,临床表现为消化道出血8例,腹部包块4例,肠梗阻3例,慢性腹痛6例,肠穿孔并弥漫性腹膜炎2例。术前均行胶囊内镜检查,胶囊内镜发现10例,诊断率43.5%,包括CT诊断6例;余13例手术探查确诊。全组均行手术治疗,良性肿瘤9例,恶性肿瘤14例。随访6个月至10年,良性肿瘤9例全部存活;恶性肿瘤死亡8例,存活6例。结论胶囊内镜有助于发现小肠肿瘤。腹腔镜探查或剖腹探查结合术中内镜检查可提高其早期诊断率,从而提高治疗效果。

Objective To analyze the diagnosis and treatment of primary small intestinal tumors and generalize such experience.Methods Clinical data of patients with primary intestinal tumor from January2004 to January 2014 in two hospitals were retrospectively analyzed.The diagnosis and treatment experiences were analyzed.Results A total of 23 patients were diagnosed with primary intestinal tumor.The patients presented with alimentary tract hemorrhage in 8,abdominal mass in 4,intestinal obstruction in 3,chronic abdominal pain in 6,and intestinal perforation complicated with diffuse peritonitis in 2 cases.All patients were tested by capsule endoscopy and CT scan.Ten and 6 cases were diagnosed with intestinal tumor by capsule endoscopy and CT scan respectively with accuracy rates of 43.5%and 26.1%,the other 13 patients were diagnosed through laparotomy.All patients received operation and pathology revealed benign tumor in 9,and malignant tumor in 14 cases.After following up from 6 months to 10 years,all 9 benign cases and 6malignant cases survived.Conclusions Capsule endoscopy is useful to diagnose small intestinal tumor.Laparotomy and laparoscopy combined with intra-operative endoscopy can increase the early diagnosis of primary small intestinal tumor.