儿童原发性肠道淋巴瘤继发肠套叠的手术治疗  

Surgical treatment on secondary intussusception with primary intestinal lymphoma in children

作　　者：黄召[1] 刘登辉[1] Huang Zhao;Liu Denghui(The Second Department of General Surgery,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院普外二科,长沙410007

出　　处：《临床小儿外科杂志》2023年第2期163-167,共5页Journal of Clinical Pediatric Surgery

基　　金：国家临床重点专科建设项目-湖南省儿童医院小儿外科(湘卫医发[2022]2号)

摘　　要：目的探讨外科手术对于儿童原发性肠道淋巴瘤继发肠套叠的治疗意义。方法回顾性收集湖南省儿童医院2017—2020年收治的12例原发性肠道淋巴瘤继发肠套叠并接受手术治疗的患儿临床资料,总结分析患儿临床表现特点、诊治过程以及预后情况。结果12例均为男性,年龄(8.77±2.99)岁,临床表现为腹痛、呕吐、血便,均以肠套叠急诊入院,均经空气灌肠复位失败转急诊手术治疗,手术复位均成功并切除病变段肠管,术后均恢复良好。病理诊断均为非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL),其中Ⅰ期1例,Ⅱ期7例,Ⅲ期3例,Ⅳ期1例。11例术后予及时化疗,预后良好;1例(Ⅳ期)失访。结论大年龄儿童肠套叠需考虑原发性肠道淋巴瘤继发肠套叠的可能,应及时手术切除原发病灶,患儿通常预后良好,不影响后续治疗。Objective To investigate and analysis surgical treatment on secondary intussusception of primary intestinal lymphoma in children.Methods A retrospective analysis was made on 12 children who received surgical treatment after secondary intussusception with primary intestinal lymphoma from January 2017 to 2020 in the Hunan Children's Hospital.And some tips about operation were made simultaneously.Results All the 12 children were emergency admission due to intussusception as the first manifestation.Intussusception reduction and nidus local resection were performed successfully for each case in emergency operation after air enema failed in reduction.All the 12 cases received satisfied postoperative recovery and were diagnosed as non-Hodgkin lymphoma(NHL).1 case was stageⅠ,7 cases were stageⅡ,3 cases were stageⅢ,1case was stageⅣ.11 cases had received combined chemotherapy in time after operation,and satisfied postoperative recovery by now.The stageⅣcase refused combined chemotherapy and had not reviewed ever.Conclusion Primary intestinal lymphoma should be concerned in older children with intussusception.Surgical treatment with nidus local resection should be performed as quickly as possible.There would be good further prognosis and rare negative effects in subsequent treatment in common.

关 键 词：淋巴瘤 非霍奇金 肠套叠 外科手术 治疗结果 儿童 

分 类 号：R726.5[医药卫生—儿科] R735.3[医药卫生—临床医学]