原发性十二指肠肿瘤手术疗效分析  

Analysing the operational therapeutic effect of primary duodenal tumor

作　　者：季超超[1,2] 王巍[3] 刘兴国[2] 张东[2] 李之令[2] 吴辉[2] 冯德元[2] 

机构地区：[1]新疆医科大学,乌鲁木齐830000 [2]兰州军区乌鲁木齐总医院肝胆外科 [3]兰州军区乌鲁木齐总医院心血管内科

出　　处：《中华临床医师杂志（电子版）》2013年第9期77-80,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨原发性十二指肠肿瘤手术疗效和预后因素。方法对2001年5月至2012年7月41例行外科手术切除治疗并经术后病理证实的原发性十二指肠肿瘤患者的临床资料进行回顾性分析。采用单因素和多因素分析评估预后因素与术后生存期的关联性。结果主要的临床表现有上腹部不适27例、黄疸19例、消瘦12例、食欲缺乏4例;术后总体5年生存率为62.3%,行胰十二指肠切除术27例(65.9%)和行局部肿物切除术10例(24.4%),其中26例十二指肠恶性肿瘤患者行胰十二指肠切除术术后5年生存率为50.5%;行其他术式4例。在单因素分析中,肿瘤的性质(P=0.036),恶性肿瘤的大小(P=0.033)和分期(P=0.010)与预后有关。结论胰十二指肠切除术和局部切除术均是延长生存期的可行而有效治疗方法;肿瘤的性质,恶性肿瘤的大小和分期可影响患者预后。Objective To investigate the treatment effect of surgery and the prognostic factors of primary duodenal tumor. Methods From May 2001 to July 2012, the medical records of 41 patients with primary duodenal tumor who underwent resection were retrospectively reviewed. Univarlate and multivariate analyses were performed to evaluate the correlation of prognostic factors and survival time after resection. Results The main clinical symptoms were discomfort of upper abdomen （ 27 cases ）, jaundice （ 19 cases ）, athrepsy （ 12 cases ） and anorexia （ 4 cases ）. Overall survival after resection was 62. 3% at 5 years in this study. 27 eases（65.9% ）in pancreatioduodenectomy and 10 cases（24. 4% ）in local resection, the 5 years survival rate of the 26 eases with duodenal malignancy underwent pancreaticoduodenectomy was 50. 5%. 4 cases in other operations. In the univariate, the nature of the tumor（ P = 0. 036）, the size of cancer（P = 0. 033 ） and TNM stage （ P = 0. 010 ）, which were associated with the survival time. Conclusion Panereatioduodenectomy and local resection were the effective and feasible treatments which could prolong the life span after resection. The nature of the tumor and the size of malignancy and TNM stage were of influence on the life span after resection.

关 键 词：十二指肠肿瘤 腺癌 胰十二指肠切除术 预后 

分 类 号：R735.3[医药卫生—肿瘤]