十二指肠癌的诊治分析  

Diagnosis and treatment of carcinoma of the duodenum

作　　者：吴健雄[1] 邵永孚[1] 荣维淇[1] 单毅[1] 崔修铮[1] 高继东[1] 吴铁成[1] 毕建军[1] 冯强[1] 郑朝旭[1] 车旭[1] 易进[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院腹部外科,北京100021

出　　处：《中华普通外科杂志》2002年第8期465-466,共2页Chinese Journal of General Surgery

摘　　要：目的提高十二指肠癌的诊治水平。方法　对 4 5例十二指肠癌的诊治方法及预后作回顾性分析。结果行纤维十二指肠镜检查的十二指肠癌确诊率为 95 % (2 0 / 2 1) ,十二指肠X线低张造影检出率为 96 % (2 2 / 2 3) ,腹部B超及CT的检出率分别为 2 9% (13/ 4 5 )及 73% (19/ 2 6 ) ,5例行核磁共振 (MRI)检查 ,4例显示肿瘤。手术治疗 4 4例 ,肿瘤切除率为 5 3% (2 4 / 4 5 ) ,根治性切除率为 4 2 %(19/ 4 5 )。根治术后 1、3、5年生存率分别为 91%、39%、2 6 % ,肿瘤未切除组的中位生存期仅为 5个月。结论联合应用纤维十二指肠镜和十二指肠低张造影能较理想地诊断各段十二指肠肿瘤 ,B超、CT及MRI均能判断梗阻性黄疸者的梗阻部位 ,且有助于检出转移瘤。手术切除肿瘤是有效的治疗方法。ObjectiveTo improve the diagnosis and treatment of duodenal carcinoma (DC).Methods A retrospective study was made on the diagnosis, treatment and prognosis of 45 duodenal carcinoma patients. Results The detection rate of DC by duodenoscopy was 95% (20/21), 96% (22/23) by hypotonic duodenography, 29% (13/45) by B ultrasound, 73% (19/26) by CT, and 80% (4/5) by MR. Forty four cases underwent surgery with resection rate of 53% (24/45), radical resection rate of 42% (19/45). The postoperative (radical resection) 1, 3, 5 year survival rate was 91%, 39%, and 26%, while the median survival time was 5 months in cases with unresectable tumor. Conclusions Duodenoscopy and hypotonic duodenography are ideal tools for the diagnosis of DC. For DC cases with obstructive jaundice, B ultrasound, CT and MR could show the obstructive portion and the metastasis.Radical resection is the mainstay for a long term survival.

关 键 词：十二指肠肿瘤 十二指肠镜检查 胰头十二指肠切除术 诊断 

分 类 号：R735.31[医药卫生—肿瘤] R656.64[医药卫生—临床医学]