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目的探讨原发性小肠肿瘤的诊治经验,以提高对原发性小肠肿瘤的诊治水平。方法回顾性分析近20年来收治并经过手术及病理确诊的68例原发性小肠肿瘤的临床资料,诊断及治疗情况。结果68例中良性肿瘤占30.8%(21/68),恶性肿瘤占69.1%(47/68)。恶性肿瘤以腺癌多见占44.4%(19/47)。本组常见症状为腹痛69.1%(47/68),消化道出血41·1%(28/68)和腹部肿块13.2%(9/68)。术前误诊率为70.5%(48/68)。65例均手术治疗,其中急诊手术为34.9%(24/68),本组无手术死亡。随访恶性肿瘤患者1、3、5年生存率分别为65.8%、42.1%、20.3%。结论小肠肿瘤缺乏特异性症状和体征,术前误诊率高,急诊手术率高,对诊断不明者,应采用各种检查,必要时剖腹探查。治疗应以手术切除为主,恶性肿瘤应辅以化疗。
Objective To investigate the diagnosis and treatment of primary small bowel tumors to improve the diagnosis and treatment of primary intestinal tumors. Methods The clinical data, diagnosis and treatment of 68 cases of primary small intestine tumor who had been treated and confirmed by operation and pathology in recent 20 years were retrospectively analyzed. Results 68 cases of benign tumors accounted for 30.8% (21/68), malignant tumors accounted for 69.1% (47/68). Malignant adenocarcinoma more common accounted for 44.4% (19/47). Common symptoms in this group were abdominal pain (69.1%, 47/68), gastrointestinal bleeding (41/18) and abdominal mass (13.2%, 9/68). Preoperative misdiagnosis rate was 70.5% (48/68). 65 cases were treated surgically, of which emergency surgery was 34.9% (24/68), the group no operative death. Follow-up of patients with 1, 3, 5-year survival rates were 65.8%, 42.1%, 20.3%. Conclusions The small intestine tumor lacks specific symptoms and signs. The preoperative misdiagnosis rate is high and the rate of emergency operation is high. For those with unknown diagnosis, various examinations should be taken and laparotomy should be taken if necessary. The treatment should be based on surgical excision, malignant tumor should be supplemented with chemotherapy.