乙状结肠肿瘤的诊断与治疗  

Diagnosis and treatment of sigmoid tumor

作　　者：童仕伦[1] 唐滔[1] 王竹平[1] 

机构地区：[1]武汉大学人民医院普外科,430060

出　　处：《腹部外科》2002年第4期212-213,共2页Journal of Abdominal Surgery

摘　　要：目的　探讨乙状结肠肿瘤的诊治方法。方法　回顾分析了 198例乙状结肠肿瘤诊疗经过。结果　 198例中恶性肿瘤 193例 (97.5 %) ,良性肿瘤 5例 (2 .5 %)。其临床表现依次为便血(6 3.7%) ,排便习惯改变 (32 .7%) ,腹痛 (2 9.3%) ,腹胀 (11.5 %) ,急性肠梗阻 (8.6 %) ,包块 (6 .8%)。181例经纤维结肠镜明确诊断 ,17例经剖腹探查明确诊断。全组均行手术治疗。其中根治性切除140例 (70 .6 %) ,姑息性切除 34例 (17.2 %) ,造瘘 18例 (9%) ,单纯探查 6例 (3.2 %)。发生肠瘘 4例(2 %) ,无手术死亡病例。结论　乙状结肠肿瘤临床表现无特异性 ,对不明原因便血及排便习惯改变应及时行结肠镜检查以明确诊断。根治性切除是乙状结肠肿瘤的最佳治疗方法。伴孤立肝转移灶、可一并切除。乙状结肠肿瘤并急性肠梗阻可行I期结肠切除吻合术。Objective To investigate the diagnosis and treatment of sigmoid tumor. Methods The clinical data of 198 patients with sigmoid tumor were analyzed retrospectively.Results Of the 198 patients with sigmoid tumor, 193 were malignant and the remaining 5 benign. Clinical manifestations of all cases included hematochezia ( 63.7%), defecation habit changing ( 32.7%), abdominalgia ( 29.3%), abdominal distension ( 11.5%), actue ileas ( 8.6%) and mass ( 6.8%). 181 cases were diagnosed by fibercoloscope and 17 cases by exploratory laparotomy. All cases received surgical treatments including radical operation ( 70.6%), palliative excision ( 17.2%), fistulation ( 9%) and simple exploration ( 3.2%). There was no dead patient except for 4 with intestinal fistula. Conclusions The patients with sigmoid tumor had no special clinical manifestation. Fibercoloscopy should be done in the patients with no reason hematochezia and defecation habit changing. The optimal treatment was radical operation of sigmoid tumor. Concomitant solitary liver metastasis could be removed at the same time. Sigmoid tumor associated with acute ileus could be treated with stage I colectomy.

关 键 词：乙状结肠肿瘤 诊断 治疗 

分 类 号：R735.35[医药卫生—肿瘤]