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目的探讨空回肠肿瘤与结直肠肿瘤的临床及内镜特征,以提高对这两种部位肿瘤的认识。方法回顾性分析双气囊小肠镜检出的空回肠肿瘤及结肠镜检出的结直肠肿瘤的临床表现、病变部位、组织学类型及内镜下表现,并进行对比。结果小肠镜检查162例,检出空回肠肿瘤21例(13.0%,21/162);结肠镜检查7258例,共检出结直肠肿瘤349例(4.8%,349/7258)。空回肠肿瘤患者以小肠出血为主要症状95.2%(20/21)。21例肿瘤中病变位于空肠19例,回肠2例;检出间质瘤20例,腺癌1例。结直肠肿瘤患者以便血为首发症状51.9%(181/349)。349例肿瘤中病变位于直肠53.0%(185/349);检出腺癌330例(94.6%),淋巴瘤7例(2.0%),类癌6例(1.7%),间质瘤6例(1.7%)。癌、淋巴瘤、类癌、间质瘤的内镜下表现各不相同。结论空回肠肿瘤以空肠间瘤最多见。结直肠肿瘤以腺癌为主,且直肠为最好发部位。小肠镜、结肠镜结合病理检查是确诊空回肠及结直肠肿瘤的最有效方法。
Objective To investigate the clinical and endoscopic features of the empty ileum and colorectal tumors in order to improve the understanding of these two tumor types. Methods The clinical manifestations, pathological changes, histological types and endoscopic findings of the ileocecal tumors detected by double balloon enteroscopy and colorectal tumors detected by colonoscopy were retrospectively analyzed and compared. Results There were 162 cases (11.0%, 21/162) diagnosed by enteroscopy and 7258 cases by colonoscopy. Colorectal neoplasms were detected in 349 cases (4.8%, 349/7258). The majority of patients with ileocecal tumor showed small intestinal bleeding as the main symptom (95.2%, 20/21). Among the 21 cases, 19 were jejunal and 2 were ileum, 20 were detected as stromal tumors and 1 was adenocarcinoma. Patients with colorectal cancer in order to blood as the first symptom? My 51.9% (181/349). Among the 349 tumors, 53.0% (185/349) were in the rectum; 330 (94.6%) were adenocarcinoma, 7 (2.0%) were lymphoma, 6 were carcinoid (1.7%), 6 were stromal tumors 1.7%). Cancer, lymphoma, carcinoid, stromal tumors endoscopic performance vary. Conclusion The most common jejunostoma is empty jejunum. Colorectal cancer with adenocarcinoma-based, and the rectum is the best hair site. Enteroscopy, colonoscopy combined with pathological examination is the most effective method of diagnosis of ileum and colorectal tumors.