出血型空回肠肿瘤的诊断和外科治疗  

DIAGNOSIS AND SURGICAL TREATMENT OFHEMORRHAGIC JEJUNOlLEAL TUMORS

作　　者：蔡成机[1] 凌跃新[1] 

机构地区：[1]上海医科大学中山医院外科

出　　处：《中国普通外科杂志》1994年第2期65-68,共4页China Journal of General Surgery

摘　　要：１９５９年９月到１９９１年４月间，我院共收治出血型空回肠肿瘤３２例。１４例（４４％）为良性肿瘤（平滑肌瘤５例，多发性腺瘤２例，脂肪瘤２例，血管瘤５例）；１８例（５６％）为恶性肿瘤（平滑肌肉瘤１０例，腺癌４例，类癌１例，恶性淋巴瘤３例），其中仅９例（５０％）恶性肿瘤行根治性切除。本病临床表现多无特征性，主要表现为：①出血：黑粪３２例（１００％），其中明显便血１８例（５６％），伴血容量性休克８例（２５％）；②腹痛１０例（３１％）；③腹块１０例（３１％）。本病术前确诊甚难，钡餐及小肠低张检查阴性者不能排除空回肠肿瘤的可能，选择性肠系膜上动脉造影可视为进一步检查空回肠病变的一种有效方法。对可疑的病例应及时施行剖腹探查。由于术中对空回肠粘膜下和壁间肿瘤极难鉴别其良、恶性。故选择行根治性切除似较合理。rom September 1958 to April 1991 , 32 cases of hemorrhagic jeJunoileal tu-mors were treated. There were 14 cases (44%) of benign tumors includingleiomyoma. polypoidadenoma, lipoma and angioma; the remaining 18 cases(56%) were malignancy and consisted of leiomyosarcorna , adenocarcinoma , car-cinoid and lyrnphoma. Only 9 cases (50%) of malignant tumors were treated byradical resection. The clinical features were noncharacteristic and were as fol-lows: ①hernorrhage such as melena in 32 patients (100%). Among those pa-tients . there were hematochezia in 18(56%),hypovolemic shock in 8 (25%) ; ②abdominal pain in 10 (31%) and ③abdominal mass in 10(31%). Accurate diag-nosis of hemorrhagic jejunoileal tumors is very difficult before operation. Thenegative results on barium meal and hypotonic small intestine examination do notexclude the possibility of jejunoileal tumor. Selective arteriography of superiormesenteric artery is considered as an effective method to further demonstrate alesions in jejunoileum. Laparotomy should be performed as a diagnostic maneu-ver in suspected patients. Because the differentiation between benign and malig-nant tumors is extremely difficult even during operation. radical resection is thebest choice of treatment.

关 键 词：出血型 空回肠 回肠肿瘤 诊断 治疗 

分 类 号：R735.33[医药卫生—肿瘤]