空回肠间质瘤13例诊治分析

目的　探讨空回肠间质瘤的诊断和治疗经验。方法　对我院 1993年 10月～ 2 0 0 4年 1月收治的有完整资料的 13例空回肠间质瘤病例进行回顾性分析 ,本组患者均经术后病理和免疫组化证实。结果　本组患者主要临床表现为消化道出血、腹痛。发病至确诊时间 2个月至 7年。剖腹探查确诊 7例 ,腹腔镜腹腔探查确诊 4例 ,术前确诊的仅 2例。随访 2个月至 9年 ,除 1例死于其它疾患外 ,余 12例均健在 ,无空回肠间质瘤复发病例发现。结论　小肠间质瘤预后甚好 ,但本病缺乏特征性的临床表现及有效的诊断手段 ,易致长期延误诊治 ;对长期不明原因的消化道出血患者 ,及早行剖腹探查或腹腔镜腹腔探查是避免小肠间质瘤长期延误诊治 ,改善患者预后的关键

Diagnose and treatment of stromal tumor of jejunum and ileum:experience in 13 patients

Objective To summarize the experience in the diagnosis and treatment of stromal tumor of jejanum and ileam.Methods Thirteen patients with stromal tumor of jejunum and ileum confirmed by pathology after operation were retrospectively reviewed in our Hospital from May 1993 to Oct.2003.Results The major clinical signs of stromal tumor of jejunum and ileum included:digestive duct hemorrhage,abdomen pain.The period of patients having clinical symptom before operation in this group was from 2 mouths to 7 years.In this group,7 cases were diagnosed by exploratory laparotomy for melena,4 cases diagnosed by laparoscopic laparotomy for melena.Only two case was diagnosed by small intestine endoscopy before operation.During a follow-up of 2 mouth to 9 years,12 patients survived today except one case died of other disease.No patients of stromal tumor of jejunum and ileum had recurrence in this group.Conclusion Stromal tumor of jejunum and ileum has better prognosis, but this disease is lack of special clinical symptom,sign and effective examination methods,so it is difficult to diagnose early.Digital subtraction angiography and radionuclide imaging are helpful to diagnose this disease.Exploratory laparotomy is first choice for these patients with suspicious stromal tumor of jejunum and ileum.