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目的总结原发性十二指肠肿瘤的临床特点,探讨其诊断及治疗方法。方法回顾性分析徐州医学院附属医院2009年1月至2014年5月期间收治的118例原发性十二指肠肿瘤患者的临床资料,其中良性5例,恶性113例。结果本组患者的临床表现缺乏特异性。各种检查方法的检出率胃十二指肠内镜为90.8%(69/76)、ERCP为92.3%(24/26)、MRCP为88.1%(37/42)、CT为68.7%(46/67)、B超为38.3%(41/107)。好发部位为十二指肠降部。良、恶性肿瘤的主要病理类型分别为腺瘤和腺癌。5例良性肿瘤均行手术切除,术后3年均健在。113例恶性肿瘤中,行手术治疗93例,术后3年生存率为45.2%(42/93);另外20例患者拒绝治疗,3年内患者均死亡。结论对原发性十二指肠肿瘤,在临床工作中,需结合内镜、影像学和实验室检查,早发现、早诊断。综合考虑患者基础情况及肿瘤生长情况,选择最有利于患者的治疗方案,从而改善患者预后,提高生活质量。
Objective To summarize the clinical features of primary duodenal tumors and to explore its diagnosis and treatment. Methods The clinical data of 118 patients with primary duodenal tumors admitted to the Affiliated Hospital of Xuzhou Medical College from January 2009 to May 2014 were retrospectively analyzed. Among them, 5 were benign and 113 were malignant. Results The clinical manifestations of this group of patients lack specificity. The detection rates of various examination methods were 90.8% (69/76) for endoscopy of gastro-duodenum, 92.3% (24/26) for ERCP, 88.1% (37/42) for MRCP and 68.7% for CT / 67), B-38.3% (41/107). Good for duodenal descending part of the site. The main pathological types of benign and malignant tumors are adenoma and adenocarcinoma respectively. All 5 cases of benign tumors were surgically removed and survived 3 years after surgery. In 113 malignant tumors, 93 cases were treated surgically and the 3-year survival rate was 45.2% (42/93). In addition, 20 patients refused treatment and all patients died within 3 years. Conclusion For primary duodenal tumors, in clinical work, combined with endoscopy, imaging and laboratory tests, early detection, early diagnosis. Considering the basic situation of patients and tumor growth, select the treatment program that is most conducive to patients to improve patient prognosis and improve quality of life.