小肠腺癌63例诊治分析  

Clinical analysis of 63 cases of small bowel adenocarcinoma

作　　者：李杰[1] 段艳霞[1] 唐楷杰 王志亮[1] 侯妮[2] 徐心[1] 

机构地区：[1]西安交通大学医学部第二附属医院普通外科,西安710004 [2]西安交通大学医学部基础医学院细胞生物与遗传学系

出　　处：《临床外科杂志》2017年第7期534-536,共3页Journal of Clinical Surgery

基　　金：国家自然科学基金资助项目(81172358)

摘　　要：目的总结小肠腺癌的诊治经验。方法小肠腺癌患者63例,术前胃镜、小肠镜检查确诊39例;影像学检查(胃肠造影,CT,磁共振)确诊12例,经内镜逆行胰胆管造影确诊5例;手术探查确诊7例。56例患者均行手术治疗。对患者的肿瘤分期、手术方式和生存状况进行分析。结果 63例小肠腺癌患者主要临床表现为腹痛、消化道梗阻和出血。十二指肠为高发部位。早期诊断率低,本组患者中Ⅲ期占60.32%,Ⅳ期占30.16%。63例腺癌患者总1年生存率为60.32%,总2年生存率仅39.69%,十二指肠腺癌较空、回肠腺癌患者预后差。肿瘤分期、手术方式及淋巴结转移明显影响患者术后生存。结论提高早期诊断率,根治性手术切除是小肠腺癌的临床诊治关键。Objective To summarize the diagnosis and treatment experience of small bowel adenocarcinoma（ SBA）. Methods Data of 63 cases of SBA were analysed. Preoperative gastroscopy,enteroscopy examination confirmed 39 cases. Imageological examination（ gastroenterography,CT,MRI） confirmed 12 cases. Endoscopic retrograde cholangiopancreatography confirmed 5 cases. Operations research confirmed 7 cases. 56 patients were performed surgical treatment. Patients＇ tumor stage,operation method and living conditions were analyzed. Results The clinical presentations were nonspecific,including abdominal pain,gastrointestinal obstruction,bleeding. Early diagnosis was difficult,cases in stage Ⅲ was 60. 32%,stage Ⅳ 30. 16%. The 1-year survival was 60. 32% and 2-year survival only 39. 69%. Survival of duodenal adenocarcinoma was worse than jejuna and ilea adenocarcinoma. Stage,surgery type,and lymph node invasion were correlated with survival. Conclusion Early diagnosis and curative resection are critical to the outcome of small bowel adenocarcinoma.

关 键 词：小肠腺癌 诊断 治疗 预后 

分 类 号：R735.32[医药卫生—肿瘤]