原发性小肠恶性肿瘤的诊治

目的探讨原发性小肠恶性肿瘤临床表现的共同规律和有效的诊断方法及治疗措施,以利早期诊断与提高疗效。方法对７５例原发性小肠恶性肿瘤进行分析,生存率计算用寿命表法,生存分析用ＣＯＸ模型。结果１３例做Ｘ线胃肠钡餐检查,诊断准确率达８４．６％。根治性切除术后１,３,５年生存率分别为８７．５％、６８．７％和４８．１％,姑息性切除术后１,３,５年生存率分别为５７．９％、３３．８％和２４．１％。用ＣＯＸ模型对各临床因素进行预后分析,选入模型的因素有年龄、组织学类型、肿瘤部位和手术方式。结论Ｘ线胃肠钡餐检查是最有价值的诊断方法。根治性手术切除是最有效的治疗手段。影响原发性小肠恶性肿瘤预后的因素有年龄、组织学类型、肿瘤部位和手术方式,而化学治疗意义不大。

Diagnosis and treatment of primary malignant tumors of the small bowel

Objective To study the clinical characteristics, effective diagnostic methods and therapeutic measures of primary malignant tumors of the small bowel so as to improve therapeutic effect. Methods In this paper 75 cases of primary malignant tumors of the small bowel were analyzed. Survival rates were calculated with Life Table, and computer COX multivariate analysis model was used for survival analysis.Results The most frequent clinical manifestations of primary malignant tumors of the small bowel were abdominal pain, abdominal mass, emaciation and intestinal obstruction. Gastrointestinal barium meal roentgenography was performed in 13 cases, with an accurate diagnostic rate of 84.6%. The 1 ,3 and 5 year survival rate after radical resection was 87.5%, 68.7% and 48.1%, respectively, while that for palliative resection was 57.9%, 33.8% and 24.1%, respectively. The factors including age, histological type, tumor site and type of resection were selected into COX model in survival analysis. Conclusion For primary malignant tumors of the small bowel, gastrointestinal barium meal roentgenography is the most valuable method for diagnosis, and surgical radical resection is the most effective therapy. The significant prognostic factors are age, histological type, tumor site and type of resection. Chemotherapy had no effect on prognosis.