目的:探讨原发性小肠肿瘤的临床特点、诊断及治疗方法, 提高对原发性小肠肿瘤的诊断水平及鉴别能力,降低误诊率。方法:对我院 1993~2008 年收治的 59 例原发性小肠肿瘤的临床资料进行回顾分析。结果:小肠肿瘤起病隐匿,缺乏特异症状,临床表现有腹痛、贫血、消瘦、便血、肠梗阻及发热等,术前经行内窥镜、X 线、B 超及 CT 等检查,术前确诊仅有 11 例,误诊率达 81.36 %。十二指肠 18 例(30.51 %),空肠 13 例(22.03 %),回肠 29 例(49.15 %)。59 例均经手术证实诊断,其中良性肿瘤 14 例(23.73 %),恶性肿瘤 45 例(76.27 %), 腺癌发病率最高 22 例(37.29 %)。良性肿瘤行了局部肠壁或肠段切除,恶性肿瘤 19 例进行根治性切除,其他行姑息切除或改道。本组病例中无围手术期死亡病例。45 例恶性肿瘤病例中, 25 例患者术后进行了2~6 次不等的辅助化疗并获得随访 6 个月至 5 年,39 例死亡,存活 5 年以上 6 例。结论:原发性小肠肿瘤恶性率高,临床上往往缺乏特征性表现,目前临床上没有有效的诊断手段和方法,误诊率较高,预后差。因此,临床医师对本病的警惕性是诊断此病的关键所在。对反复腹痛、消瘦、腹部包块、肠梗阻、不明原因消化道出血等临床表现患者应高度怀疑小肠肿瘤,及早剖腹探查,改善预后。
Citation：
YUAN Jiatian,WANG Wei,ZHOU Zhiqiang,et al.. Clinical Analysis of 59 Cases of Primary Small Intestinal Tumors. West China Medical Journal, 2009, 24(6): 1526-1529. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 1. BEYROUTIML, ABID M, BEYROUTI R. Sarcomas of the small intestine[J]. Presse Med, 2005, 34 (5): 385-390.
- 2. HATZARAS I, PALESTY JA,ABIR F, et al. Small2bowel tumors: ep idemiologicand clinical characteristics of 1260 cases from the Connecticut tumorregistry[J]. Arch Surg, 2007, 142 (3): 229.
- 3. 陆星华, 钱家鸣. 消化系疾病诊断与诊断评析[J]. 上海: 上海科学技术出版社, 2006: 191.
- 4. 唐镇, 初兆毅, 韩英. 原发性小肠肿瘤的诊断与治疗体会[J]. 中华普通外科杂志, 2006, 21 (4): 299.
- 5. 杨维良,张新晨,闰朝岐,等. 原发性小肠肿瘤 305 例临床分析[J]. 中华肿瘤杂志,2007,10 (29):781-783.
- 6. CAZZATO IA, CAMMAROTA G, NISTA EC, et al. Diagnosticand therapeutic impact of doubleballoon enteroscopy(DBE) in a series of 100 patients with suspected smallbowel diseases[J]. Dig Liver Dis, 2007, 39 (5): 483-487.
- 7. BAILEY AA, DEBINSKI HS, APPLEYARD MN, et al. Diagnosisand outcome of small bowel tumors found by capsuleendoscopy: a threecenter Australian experience[J]. Am JGastroenterol, 2006, 101 (10): 2237-2243.
- 8. 秦新裕. 小肠肿瘤的诊治现状及发展趋势[J]. 中国实用外科杂志,2008,11(11):929.
- 9. SCAIFE C. Small bowel adenocarcinama distal to the ligament oftreitz[M]//Advanced therapy in surgical oncology[J]. Hamiltoni: BC Decker Inc, 2008: 224-229.
