良、恶性小肠平滑肌肿瘤的诊治体会  

The Diagnosis and Treatment for Benign and Malignant Smooth Muscle Tumors of Small Intestine

作　　者：李克敏[1] 刘彤[1] 董英[1] 王鹏志[1] 

机构地区：[1]天津医科大学总医院普通外科 天津普通外科研究所,300052

出　　处：《天津医药》2000年第1期26-28,共3页Tianjin Medical Journal

摘　　要：总结分析37例小肠平滑肌肿瘤的临床诊治资料。术前明确小肠肿瘤诊断者20例,以其并发症行急症手术确定诊断者9例,误诊者8例。全部病例均以病理确诊,包括平滑肌瘤8例、平滑肌肉瘤28例和平滑肌母细胞瘤1例。腔外型生长18例,多以腹部肿块、消化道出血就诊。腔内型生长12例,多以肠梗阻就诊。腔内-腔外型6例,壁间型1例。恶性肿瘤最长径显著大于良性肿瘤,并有发热、消瘦等恶液质表现,但二者的发病年龄差异不显著。结论认为,腔外型生长肿瘤难于早期发现,消化道检查也易于漏诊,应充分重视CT扫描、MRI和选择性血管造影检查的作用。肿瘤生长方式与其性质无关,术中冰冻病理检查多可为手术方式的选择提供依据,对肿瘤性质不明者以采取根治性手术为宜。Objective: To identify the clinical feature and avoid misdiagnosis of benign and malignant smooth muscle tumors of small intestine. Methods: The clinical material of 37 cases of smooth muscle tumor were studied retrospectively. Results: In 37 patients,20 cases were diagnosed as small intestinal tumors before operation,9 cases accepted emergency surgery because of the complications of small intestinal tumor,and 8 cases got misdiagnosed. All patients had the operations performed, getting the pathological diagnosis including leiomyoma (8 cases),leiomyosarcoma (28 cases) and leiomyoplastoma (1 case). There were 18 cases with extra-lurninal growing tumors (most of them manifested abdominal mass or hemorrhage of digestive tract) ,12 cases with intra-luminal type tumor (intestinal obstruction was the frequent clinical feature) ,6 cases with in-tra-extra-luminal type tumor and 1 case with the tumor growing within the luminal wall. The diameters in leiomyosarcomas which were uswally associated with fever and dyscrasia were larger than leiomyomas. There were no difference in age between the cases Conclusions:The tumors growing extralumen were difficult to diagnose in early stage in spite of the careful examination of intestinal tract. CT scan and DSA could help to diagnose of smooth muscle tumors in small intestine. The growing type had negative correlation between benign and malignant tumors. It is suggested that freezing tissue pathological examination must be used during operation, and radical operation may be the suitable decision for the unknown benign and malignant tumors.

关 键 词：平滑肌肉瘤 小肠肿瘤 诊断 治疗 

分 类 号：R735.32[医药卫生—肿瘤]