原发性小肠淋巴瘤手术干预的单中心观察分析  

The observation and analysis of surgical intervention for primary small intestinal lymphoma in a single-center

作　　者：刘石龙 杨加磊 逯景辉[3] LIU Shilong;YANG Jialei;LU Jinghui(Department of General Surgery,People's Hospital of Yicheng District Zaozhuang City,Zaozhuang,Shandong,277300,China;Department of General Surgery,Maternal and Child Health Centre of Zaozhuang City,Zaozhuang,Shandong,277000,China;Department of General Surgery,Qilu Hospital of Shandong Uinversity,Ji'nan,Shandong,250012,China)

机构地区：[1]枣庄市峄城区人民医院普通外科,山东枣庄277300 [2]枣庄市妇幼保健院普通外科,山东枣庄277000 [3]山东大学齐鲁医院普通外科,山东济南250012

出　　处：《当代医学》2024年第18期131-134,共4页Contemporary Medicine

摘　　要：目的分析原发性小肠淋巴瘤(primary small intestinal lymphoma,PSIL)的临床表现、相关辅助检查诊断及手术干预治疗效果,为提高临床诊治效果提供参考。方法回顾分析2015年5月至2020年10月山东大学齐鲁医院普通外科经手术干预及病理证实的30例PSIL患者的临床资料,并统计分析患者首诊情况、临床表现、影像学检查结果、手术情况及病理类型。结果30例PSIL患者中,首诊于消化内科15例,占比50.0%;首诊于普通外科11例,占比36.7%;首诊于急诊外科4例,占比13.3%。主要临床表现:腹部疼痛14例,占比46.7%;腹胀、恶心呕吐8例,占比26.7%;消化道出血5例,占比16.7%;腹部包块2例,占比6.7%;无症状1例,占比3.3%。影像学检查:27例患者行腹部CT检查均提示小肠局限性扩张、积液、肠壁增厚;13例患者行小肠镜检查提示小肠病变;2例行胶囊内镜检查提示小肠病变。手术情况:30例PSIL患者均行手术治疗,其中小肠部分切除肠吻合术23例,小肠部分切除小肠造瘘术2例,肠套叠复位+小肠部分切除术1例,小肠部分切除+左半结肠部分切除术3例,小肠部分切除+回盲部切除术1例。术后病理结果:均为非霍奇金淋巴瘤,其中弥漫大B细胞型17例,占比56.7%;T细胞型6例,占比20.0%;边缘区黏膜相关B细胞淋巴瘤3例,占比10.0%;NK/T细胞淋巴瘤2例,占比6.7%;套细胞淋巴瘤1例,占比3.3%;滤泡型淋巴瘤1例,占比3.3%。结论PSIL是较少见的消化道肿瘤,腹部CT、小肠镜检查及胶囊内镜检查均为有效检查手段,可提高诊断准确率;手术治疗是必要手段,可缓解临床症状,明确诊断,指导临床治疗。Objective To analyze the clinical manifestations,related auxiliary examination diagnosis and surgical intervention of primary small intestinal lymphoma(PSIL),and toprovide reference for improving the clinicaldiagnosis and treatment.Methods The clinical data of 30 patients with primary small intestinal lymphoma confirmed by surgical intervention and pathology in the Department of General Surgery of Qilu Hospital of Shandong University from May 2015 to October 2020 were retrospectively analyzed,and the first diagnosis,clinical manifestations,imaging results,surgical conditions and pathological types of the patients were statistically analyzed.Results Among the 30 patients with PSIL,15 cases(50.0%)were first diagnosed in the department of gastroenterology,11 cases(36.7%)were first diagnosed in the Department of General Surgery;4 cases(13.3%)were first treated in the Department of Emergency Surgery.Main clinical manifestations:14 cases of abdominal pain,accounted for 46.7%;8 cases ofabdominal distension,nausea and vomiting,accounted for 26.7%;5 cases ofgastrointestinal bleeding,accounted for 16.7%;2 cases of abdom-inal mass,accounted for 6.7%;1 case of and asymptomatic,accounted for 3.3%.Imaging examination:abdominal CT examination was performed in 27 patients showed small intestinal localized dilatation,fluid accumulation and intestinal wall thickening;enteroscopy was performed in 13 patients showed indicating small intestinal lesions;capsule endoscopy was performedin 2 patients showed indicating small intestinal lesions.Surgical condi-tions:all 30 patients with PSIL underwent surgical treatment,including 23 cases of partial small intestinal resection enterostomy,2 cases of partial small intestinal resection enterostomy,1 case of intussusception reduction+partial small intestinal resection,3 cases of partial small intestinal resec-tion+partial left hemicolectomy,1 case ofpartial small intestinal resection+ileocecal resection.Postoperative pathological results:all patients were non-Hodgkin lymphoma,included 17 cases

关 键 词：小肠 原发性淋巴瘤 症状 影像学检查 病理 手术方式 

分 类 号：R735.32[医药卫生—肿瘤]