原发性小肠肿瘤96例临床分析

Clinicopathologic analysis of primary small intestinal neoplasm in 96 cases

目的 探讨提高小肠肿瘤的诊治水平。方法 回顾性分析我院 1 9年来经手术和病理证实的 96例小肠肿瘤的临床资料。结果 恶性肿瘤占 72 .9% ;术前确诊率为 5 6 .3% ;腹痛、腹部肿块、肠梗阻、肠出血是小肠肿瘤最常见的临床表现 ;首选检查方法为小肠气钡双重造影 ,内镜和选择性肠系膜上动脉造影检查是提高其诊断率的主要方法 ;良性肿瘤行局部肠段切除 ,恶性肿瘤中 39例行根治性切除 ,1 5例行姑息性切除术 ,1 6例行各种未切除的手术。结论 小肠肿瘤术前诊断困难 。

Objective To improve the diagnostic rate and therapeutic level of primary small intestinal neoplasm.Methods 96 cases with primary small intestinal tumors treated in our hospital from 1984 to 2003 were studied retrospectively. All patients were identified by postoperative histopathological examination.Results 72.9 % of patients were malignant tumors. The key clinical features of these patients consisted of bleeding in digestive tract, bowel obstruction, abdominal pain, abdominal mass. 56.3 % of patients got the definite diagnosis of small bowel tumor preoperatively. The chief method of diagnosis is the hypotonic contrast X ray examination. Endoscopy and superior mesenteric arteriography can increase the diagnostic rate. The malignant cases underwent curative operation 39 cases, cytoreductive operation 15 cases such as simple resection of tumor, palliative operation 16 cases, respectively. Conclusion Small intestinal neoplasm is difficult to be diagnosed preoperatively. Surgery remains as the chief therapy of choice.