原发性小肠肿瘤２１例诊治分析

目的：探讨原发性小肠肿瘤的诊治方法。方法：回顾性分析我院２００５年７月～２００９年３月诊治的原发性小肠肿瘤２１例的临床资料。结果：本组十二指肠腺癌１２例，其中２例失访，８例存活，时间０.５～３年，２例死亡；空肠肿瘤４例，１例间质瘤术后１年复发、死亡，１例术后服用格列卫治疗１年余，２例腺瘤存活已３年余；２例空回肠腺癌合并梗阻术后２年余；２例回肠恶性淋巴瘤术后０.５～１年，１例回肠腺癌肝转移术后４月余，全身化疗２周期，肝癌转移灶行ＴＡＣＥ治疗１次，仍在随访中。结论：小肠肿瘤早期诊断困难，Ｘ线钡剂造影、内镜、ＣＴ及腹腔动脉数字减影血管造影（ＤＳＡ）检查是主要诊断方法，双气囊电子内镜、胶囊内镜和多排ＣＴ结合三维重建技术等新技术也已用于临床，医师应提高对小肠肿瘤的认识，手术切除是首选治疗方法。

Analysis of diagnosis and treatment of 21 cases with small intestinal primary neoplasma

Objective z To explore the effective method in the diagnosis and treatment of small intestinal primary neoplasma. Methods：The clinical date of 21 cases of primary small intestinal neoplasms were analyzed retrospectively from July 2005 to March 2009. Results：Twelve cases were diagnosed as duodenum adenocarcinoma ,2 cases of them were followed up,8 cases are still alive for 0. 5 to 3 years ,2 cases died ;4 cases were diagnosed as jejunum tumors, 2 cases of them were malignant stromal tumors, ＇after opration, one died for metastasis, the other is being treated with imatinlb for more than one year, 2 cases of jejunum benign tumors are survival for 3 years ;2 cases of jejunum/ileum adenocareinoma with the symptoms of intestinal obstructio are still alive for 2 years after opration ; 2 patients of malignant lymphoma of ileum accepted six times chemotherapy, being followed on for 0. 5 to 1 year; Four months later local interventional chemotherapy was administered to Diver of one patient with liver metastasis of ileum after opration and Two times chemo- therapy. Conclusion ：Small intestinal primary neoplasma was difficult to diagnosed before opration, which usually leads to misdiagnosis, so attention should be paid for early diagnosis. X-ray, endoscopy, CT, DSA are the ideal diagnostic methods for small intestinal primary neoplasma. Doable balloon endoscopy, capsule endoscop are new diagnostic methods in rescent years. Surgery remains the chief therapy method.