小肠原发性肿瘤31例临床分析  

Clinical Analysis of Primary Small Intestinal Tumor in 31 Cases

作　　者：陈梅 牛桂军[2] 

机构地区：[1]广西壮族自治区桂林市第六人民医院内二科,541001 [2]广西壮族自治区南溪山医院消化科

出　　处：《医学研究杂志》2009年第1期81-83,共3页Journal of Medical Research

摘　　要：目的探讨原发性小肠肿瘤的临床特点及诊断。方法回顾性分析近5年来我们所收治的31例原发性小肠肿瘤的临床和病理特征。结果小肠肿瘤大多位于十二指肠,占21/31(67.74%)。全组术前确诊率为17/31(54.84%)。其中,十二指肠肿瘤较高66.67%(14/21);空回肠肿瘤术前诊断率较低,仅3例30%(3/10)。本组患者以恶性病变28例,以腺癌占绝大多数24/31(77.42%),其次为恶性淋巴瘤4/31(12.90%)。良性肿瘤仅3例。小肠肿瘤可表现为腹痛、腹块、消化道出血、肠梗阻和黄疸、发热等。X线钡餐,特别是低张小肠气钡造影和内镜对诊断小肠肿瘤有较大帮助。选择性肠系膜上动脉血管造影对小肠肿瘤,特别是诊断困难的小肠出血有诊断价值。CT对判断肿瘤有一定帮助。结论小肠肿瘤以恶性者和腺癌多见,又以十二指肠为主。十二指肠水平部以上肿瘤以消化道内镜检查加活检为首选。低张小肠造影是有效的诊断和定位方法。肠系膜上动脉造影对血管瘤和平滑肌瘤是较好的方法。CT也有一定帮助。Objective To explore the clinical characteristics and diagnosis of primary small intestinal tumor（PSIT）. Methods Retrospective analysis of the clinical and pathological data of the 31 PSIT cases was made. Results Duodenum was the most common site 67.74% for PSIT. The confirmed diagnosis rate was 54. 84% （ 17/31 ） （ duodenum was 66. 67% ,14/21 ; ileum and jejunum was 30% , 3/ 10, respectively ）. 3 cases were benign tumors and 28 were malignant tumors. The adenocarcinoma was the most frequently seen malignant PSIT followed by lymphoma and often in duodenal. The features of the small intestinal tumor could be abdominal pain,abdominal mass, hemorrhage, obstruction ,jaundice and fever. The chief method for diagnose was barium meal X - ray examination, especially with the hypo- tonic contrast X - ray examination and endoscopy. Superior mesenteric arteriography sometimes helped in determing site of gastrointestinal haemorrhage. CT scan could be helpful in diagnosis. Conclusion Duodenal adenocarcinoma is most common PSIT,followed by malignant lymphoma. Endoscopy is the best way to find out the tumor located in duodenum and hypotonic contrast X - ray examination is effective in diagnosis and locating of small bowl tumors. Superior mesenteric arteriography is a good way to find out angioma and leiomyoma. CT scanning are also helpful.

关 键 词：小肠肿瘤 诊断 病理 

分 类 号：R735.320.4[医药卫生—肿瘤] R735.32[医药卫生—临床医学]