小儿原发性小肠肿瘤诊治分析

目的 为提高小儿原发性小肠肿瘤的诊断率，以获得早期治疗。方法 对28例原发性小肠肿瘤的病理类型、临床表现、误诊原因、治疗情况作一回顾性分析。结果 小儿小肠原发性肿瘤良性15例。恶性13例。恶性肿瘤以淋巴肉瘤为主(92．3％)。术前仅4例确诊(10．7％)，24例术中及术后获得诊断。其中继发性肠套叠而急诊手术16例(64．9％)。良性肿瘤除1例十二指肠血管瘤大出血放弃治疗外，14例全部治愈。恶性肿瘤13例术后虽化疗放疗等治疗，经随访目前仅3例存活1～8年。余分别在2个月至2年内死亡。结论 小儿原发性小肠肿瘤少见，术前诊断困难。误诊率高。常以肠套叠为首发疾病，确诊常在术中及术后获得，恶性肿瘤预后差。

Primary small intestinal tumor of children

Objective To investigate early diagnostic and therapeutic methods of primary small intestinal tumor in children.Methods Twenty-eight cases of primary small intestinal tumor were retrospectively reviewed by analyzing clinical features,pathological types,treatment and causes of misdiagnosis.Results In the 28 patients,15 cases were benign and 13 cases were malignant,in which lymphosarcoma was predominant (92.3%).only 4 cases of lymphosarcoma were diagnosed before operation(10.7%),while other 24 cases were diagnosed during or after operations.Sixteen cases(64.9%) were treated by emergency operation because of secondary intussusception.In 15 benign cases,14 cases were cured except 1 case of angioma of duodenum who was not treated for massive hemorrhage.Among 13 malignant cases,only 3 ones were lived from 1 to 8 years during follow-up while the remaining died within 2 to 24 months despite chemotherapy and radiotherapy were given.Conclusion (1)Primary small intestinal tumor of children was difficult to diagnose before operation;(2)Intussusception was the mainly clinical feature;and (3)The prognosis was bad for malignant small intestinal tumor.