原发性小肠肿瘤的诊断和治疗

目的 探讨原发性小肠肿瘤的诊断及治疗。方法 回顾性分析近17年来收治并经过手术及病理确诊的65例原发性小肠肿瘤的临床资料、诊断及治疗情况。结果 肿瘤位于十二指肠25例(38．5％)，空肠16例(24．6％)，回肠24例(36.9％)，其中恶性肿瘤47例(72．3％)，良性18例(27．7％)。本组常见症状为腹痛(70．7％)，消化道出血(46．2％)和腹部肿块(13．8％)。术前误诊率为36．9％，其中空回肠肿瘤误诊率为59．5％。65例均手术治疗，手术后死亡2例。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。对有出血、腹痛、梗阻、包块等临床表现者应怀疑本病可能；对诊断不明者，应综合采用各项检查，必要时剖腹探查。治疗应以手术切除为主，恶性肿瘤应加以化疗。

Diagnosis and treatment of primary small bowel tumors

Objective To study the diagnosis and treatment of primary small bowel tumors.Methods Retrospective analysis of the clinical data was made on the 65 cases of primary small intestinal tumors confirmed by pathological examination in our hospital in recent 17 years.Results In this group, 47 cases (72.3%)were malignant while the other 18 cases (27.7%)were benign tumors. Tumors located at duodenum ,jejunum and ileum were 25 cases(38.5%),16 cases(24.6%),and 24 cases(36.9%),respectively. The common clinical presentations were abdominal pain(70.7%), gastrointestinal hemorrhage( 46.2%) and abdomen mass(13.8%). The preoperative misdiagnosis rate was 36.9%, and the misdiagnosis rate of jejumum tumors was 59.5%. All the 65 cases underwent operation, two cases died after operation. The 1,2 and 5 years survival rates of malignant tumors were 65.8%,42.1% and 20.3% respectively. Conclusions The clinical presentation of primary small intestinal tumor is non-specific, and the misdiagnosis rate is high. For the cases with hemorrhage,intestinal obstruction and abdominal mass must think of the tumor.For the cases whose diagnosis are uncertein,comprehensive diagnostic examinations should be done,and laparotomy exploration should be considered,if it is need.The choice of treatment is surgery,and for malignant tumors the chemotherapy is necessary.