原发性十二指肠恶性肿瘤11例诊治体会  

Diagnosis and Treatment of Primary Malignant Tumors of the Duodenum ： a Report of 11 Cases

作　　者：汤衍斌[1] 马涛[1] 江小琼[1] 邹远航[1] 付世艳[1] 孙淑明[1] 

机构地区：[1]汕头大学医学院 第一附属医院 普通外科,广东 515041

出　　处：《实用医学进修杂志》2005年第3期164-167,共4页Journal of Practical Training of Medicine

摘　　要：目的： 探讨原发性十二指肠恶性肿瘤的临床表现、病理学特征及诊治手段.方法： 对我院10年来收治的经病理证实的11例原发性十二指肠恶性肿瘤患者的临床资料进行回顾性分析.结果： 发病部位：乳头区7例,降段3例,其他部位1例.临床主要表现为上腹疼痛（9 例）,黄疸（3例）和消化道出血（7例）.病理学类型以腺癌多见（10例）,胃肠道间质瘤（1例）.8例行肿瘤根治性切除术,3例行姑息性手术.结论：原发性十二指肠恶性肿瘤临床以上腹痛、黄疸、消化道出血为主要表现.但缺乏特征性.病理类型以腺癌为主,好发于十二指肠乳头区及降段.CT和B超及内镜检查是诊断检查原发性十二指肠恶性肿瘤的主要手段,手术切除是主要治疗方法,但预后甚差.Objective： To investigate the clinical manifestations,histopathological patterns, and methods of diagnosis and treatment Of primary malignant duodenal tumors. Methods： The data Of 11 patients with primary malignant duodenal tumors confirmed by pathology and admitted to our hospital over a 10 - year period were analyzed retrospectively. Results： Tumor location ： Tumors were located in the peripapilla region in 7 cases, at the descending portion of the duodenum in 3 cases, at other regions Of the duodenum in 1 cases. The common presenting symptoms and signs were abdominal pain in 9 cases, jaundice 3 cases, and gastrointestinal bleeding in 7 cases. The patho - grouping adenocarcinoma 10 cases, interstitialoma 1 case. In these patients, radical resection of tumor was performed in 8 cases,palliative resection of tumor in 3 cases. Conclusions： The common presenting symptoms and signs Of patients with primary malignant duodenal tumors were abdominal pain, jaundicc and GI bleeding, but these patients usually lack specific symptoms and signs. The chief pathologic type is adenocarcinoma and the predisposed site of occurrence is the duodenal papillary region and the descending duodenum. CT, B uhrasonography and gastroduodenoscopy are the chief measures for the diagnosis of primary duodenal malignant tumors, and surgical resection is the main modality of treatment of this disease. The prognosis of primary duodenal malignant tumors is very poor.

关 键 词：十二指肠 恶性肿瘤 原发性十二指肠恶性肿瘤 诊治体会 十二指肠乳头 消化道出血 恶性肿瘤患者 根治性切除术 胃肠道间质瘤 临床表现 病理学特征 

分 类 号：R735.31[医药卫生—肿瘤] R656[医药卫生—临床医学]