十二指肠恶性肿瘤的诊断、治疗及预后风险因素分析  

Analysis of clinical diagnosis,surgical management and prognosis in primary malignant tumor of the duodenum

作　　者：陈斌[1] 王春华[2] 王小农[1] 何晓[1] CHEN Bin;WANG Chunhua;WANG Xiaonong;HE Xiao(Department of Hepatobiliary Surgery, First Affiliated Hospital of GanNan Medical College, Ganzhou 341000, China)

机构地区：[1]赣南医学院第一附属医院肝胆外科,江西赣州341000 [2]赣南医学院基础学院,江西赣州341000

出　　处：《实用医学杂志》2018年第6期998-1002,共5页The Journal of Practical Medicine

摘　　要：目的探讨原发性十二指肠恶性肿瘤的外科诊治及预后的影响因素。方法回顾性分析2005年1月至2015年12月收治118例原发性十二恶性肿瘤患者的临床资料。结果肿瘤位于球部、降部、水平部、升部分别为7、92、12、7例,行胰十二指肠切除、十二指肠节段性切除、姑息性短路手术分别80、18、20例。术前十二指肠镜检查诊断正确率为83.02%、十二指肠低张造影诊断正确率为79.42%、腹部增强CT检查诊断正确率为47.46%、B超检查诊断正确率为29.41%。结论原发性十二指肠恶性肿瘤好发部位在降部乳头周围区,以腺癌为主。纤维十二指肠镜、十二指肠低张造影是诊断十二指肠恶性肿瘤的主要方法。胰十二指肠切除术是首选治疗方法。肿瘤的浸润深度、淋巴转移、根治手术是影响患者术后预后的独立因素。Objective To evaluate the diagnosis,surgical treatment and prognosis of primary malignanttumor of the duodenum. Methods The clinical data of 118 cases with primary malignant tumor of the duodenumwere collected and analyzed retrospectively during January 2005 to December 2015. Results Tumors located inthe first,second,third and fourth parts in 7 cases,92 cases,12 cases,and 7 cases individually. The correct di-agnosis rate of endoscopy,duodenography,abdominal enhanced CT and ultrasound was 83.02%,79.42%,47.46%and 29.41% separately. Eighty cases underwent pancreaticoduodenectomy,18 cases received segmental duodenectomand 20 cases received bypass operation. Conclusions Tumors located in papillary region account for the majorityof primary malignant tumors of the duodenum and are mainly of adenocarcinoma. Duodenography and endoscopy arethe major methods for diagnosis of primary malignant tumor of the duodenum. Pancreaticoduodeneetomy is the firstchoice of therapy for primary malignant tumor in the duodenum.

关 键 词：十二指肠肿瘤 胰十二指肠切除术 诊断 治疗 预后 

分 类 号：R735.31[医药卫生—肿瘤]