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目的:探讨十二指肠胃肠道间质瘤的诊断、手术方式和预后因素。方法:回顾性分析18例经病理证实的十二指肠胃肠道间质瘤的临床资料,包括临床症状、诊断方法、病灶部位、手术方式、病理结果和预后等。结果:18例均行手术切除治疗,11例行十二指肠肿瘤局部切除术,3例行胰十二指肠切除术(Child术),2例行肠段切除术,2例行胃大部切除术;经24个月到7年随访,5例死于转移和复发,其余13例生存,生活质量良好。随访资料显示性别、年龄、肿瘤大小和手术方法与病人的复发和死亡率无关;导致病人复发和死亡唯一危险因素是肿瘤的危险度分级。结论:上消化道出血是十二指肠胃肠道间质瘤最为常见的症状。多因素分析显示,高危分级是十二指肠胃肠道间质瘤的独立预后因素;根据肿瘤部位和大小来决定手术方式。
Objective: To investigate the diagnosis, surgical methods and prognostic factors of duodenal gastrointestinal stromal tumors. Methods: Retrospective analysis of 18 cases of pathologically confirmed duodenal gastrointestinal stromal tumors clinical data, including clinical symptoms, diagnostic methods, lesion location, surgical methods, pathological results and prognosis. Results: All 18 cases underwent surgical resection, 11 underwent local resection of duodenal tumors, 3 underwent pancreatoduodenectomy (Child surgery), 2 underwent resection of the bowel, and 2 underwent gastrectomy. After 24 months to 7 years of follow-up, 5 patients died of metastasis and recurrence, and the remaining 13 patients survived with good quality of life. Follow-up data showed that gender, age, tumor size, and surgical methods were not associated with patient recurrence and mortality; the only risk factor leading to patient recurrence and death was the risk grade of the tumor. Conclusion: Upper gastrointestinal bleeding is the most common symptom of duodenal gastrointestinal stromal tumors. Multivariate analysis showed that high-risk classification was an independent prognostic factor for duodenal gastrointestinal stromal tumors; surgical methods were determined based on the location and size of the tumor.