原发性小肠恶性肿瘤的临床诊治与分析

目的：探讨原发性小肠恶性肿瘤的临床特征及诊治经验。方法回顾性分析2003年1月至2013年1月收治的80例原发性小肠恶性肿瘤患者的临床资料。术前明确诊断39例（48．75％），误诊41例（51．25％）。全组均行手术治疗，54例行小肠肿瘤根治性切除术，26例行姑息性手术或改道术；20例患者行术后化疗。结果1例患者术后因肠瘘、感染性休克、多器官功能衰竭而死亡；无其他围手术期死亡；术后1、3、5年生存率分别为69．84％（44/63）、41．27％（26/63）、22．22％（14/63）。结论原发性小肠恶性肿瘤起病隐匿，临床表现不典型，早期诊断较困难，误诊率高，一旦确诊应尽可能行手术切除。

Clinical analysis of diagnosis and treatment of primary small intestinal malignant tumor

Objective To explore the clinical characteristics,diagnosis and treatment of primary small intestinal malignant tumor.Methods The clinical data of 80 patients with primary small intestinal malignant tumor from January 2003 to January 2013 were retrospectively analyzed.The preoperative diag-nostic rate was only 48.75%（39/80）and the misdiagnosis rate was 51.25%（41/80）.Surgical treatment was performed in all patients,including radical dissection in 54 cases and palliative resection or intestinal bypass in 26 cases.Twenty patients received postoperative chemotherapy.Results Except for 1 case of death due to intestinal fistula,septic shock and multiple organ failure,there was no other perioperative death.The 1-,3-,5-year survival rates were 69.84%（44/63）,41.27%（26/63）and 22.22%（14/63）, respectively.Conclusion It is difficult to make an early diagnosis of primary small intestinal malignant tumors due to its insidious onset and nonspecific symptoms.The misdiagnosis rate is high,and once the di-agnosis is confirmed,surgery should be performed as soon as possible.