85例原发性空回肠肿瘤临床分析  

Clinicopathological analysis of Primary Jejunoileum Neoplasm

作　　者：宋东旭[1] 李卫东[1] 

机构地区：[1]天津医科大学总医院普通外科,天津300052

出　　处：《中国中西医结合外科杂志》2011年第6期567-571,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:总结原发性空回肠肿瘤的临床病理特点,提高诊治水平。方法:回顾性分析我院近10年来85例原发性空回肠肿瘤的临床资料及随访结果。结果:良性肿瘤22例,恶性肿瘤63例,良恶性之比为1∶2.9。恶性肿瘤主要包括腺癌(22例)、恶性间质瘤(20例)、淋巴瘤(16例)等,恶性肿瘤的直径大于良性肿瘤。隐性失血、脐周隐痛与腹部包块是小肠肿瘤最常见的症状,亦是其早期诊断的警示信号。小肠肿瘤的术前确诊率为41.2%(35/85),空肠肿瘤确诊率51.4%(19/37),回肠33.3%(16/48)。22例良性肿瘤行局部或肠段切除;63例恶性肿瘤中,32例行肿瘤根治、转移病灶切除,26例行姑息性切除或减瘤荷手术,5例行短路手术。本组恶性肿瘤1、3、5年的生存率分别为80.3%、47.8%、33.8%。结论:B超、CT结合内窥镜检查是小肠肿瘤的主要诊断手段,术中冰冻、肿瘤大小有助于小肠肿瘤性质的判断,争取根治性手术是改善预后的关键。Objective To summarize the clinicopathological characters for improving in diagnose and treatment of primary jejunoileum neoplasm.Methods The data and follow-up of 85 patients with primary jejunoileum neoplasm collected from our hospital were analyzed retrospectively.Results There were 22 benign and 63 malignant tumors in this series with a ratio of 1：2.9.The 63 malignant tumors consist of 22 adenocarcinomas,20 malignant stromal tumors,16 malignant lymphomas,and etc,with larger diameters.Mild abdominal or right lower quadrant pain,occult bleeding,abdominal mass were the common clinical manifestations and alerting massage of intestine tumor.Correct preoperative diagnostic rate was only 41.2%（35/85） ,which was 51.4%（19/37） in Jejunum tumors and 33.3%（16/48） in Ileum tumors.In the series all of the 22 benign tumors were resected completely.For those 63 patients with malignant tumors,radical dissection was performed in 32 cases,palliative resection in 26 cases,and gut by-pass or biopsy in 5 cases.The 1-,3-,and 5-year survival rates in the malignant group were 80.3%,47.8%、33.8%.Conclusions B-ultrasound and CT combined enteroscopy is the key to improve localization and qualitative diagnosis of the diseases.Pathological examination of the freezing tissue during the operation as well as tumor size are beneficial to the diagnosis of primary jejunoileum neoplasm.Early radical dissection is crucial in improving the prognosis.

关 键 词：肿瘤 空回肠 诊断 病理 手术 

分 类 号：R735.33[医药卫生—肿瘤]