目的 总结原发性小肠肿瘤的临床特点、病理分类、诊治经验,以提高外科诊疗水平.方法 回顾性分析114例原发性小肠肿瘤临床资料及随访结果.结果 肿瘤位于十二指肠64例,空肠38例,回肠12例,总的术前诊断率为63.2%,包括十二指肠肿瘤术前诊断率为90.6%,空肠肿瘤为28.9%,回肠肿瘤为25.0%,按病理类型,腺癌60例,间质瘤35例,其他类型19例,本组行胰十二指肠切除术44例,部分小肠切除术57例,右半结肠根治性切除术3例,旁路手术8例,2例患者拒绝手术.其中85例术后联合辅助治疗,本组恶性肿瘤1、3年生存率分别为76.3%、40.2%.结论 原发性小肠肿瘤以腺癌为主,间质瘤已成为第二高发肿瘤,多种检查技术的联合应用可提高诊断率,手术切除是治疗小肠肿瘤的主要手段,术后根据病理类型选择敏感辅助治疗可改善预后.%Objective To summarize the clinical symptom, pathological classification and experience in the diagnosis and treatment of primary tumour of small bowel, and to improve the level of diagnosis and therapy. Methods The clinical data and follow up of 114 patients with primary small bowel tumour were analyzed retrospectively. Results 114 patients with primary small bowel tumour were studied.Tumours located at the duodenum were noted in 64 patients,at the jejunum in 38 patients ,and at the ileum in 12 patients. The rate of preoperative diagnosis rate was 63.2％ ,including a diagnosis rate of 90. 6％ for duodenal tumour,28.9％ for jejunum tumour, and 25％ for ileum tumour. The 114 primary tumours in this series consisted of 60 adanocarcinomas, 35 stromal tumours, 4 adenomas, 3 leiomyomas, 2 lipomas, and 5 neurocrionmas, 2 leiomyosarcomas, 2 lymphoms, 2 undifferentiated carcinomas. The surgical procedures included pancreatoduodenectomy in 44 patients,and segmental bowel resection in 57 patients, radical right hemicolectomy in 3 patients, bypass operation in 8 patients, while 2 patients refused surgical treatment. The 1 -3 - year survival rates in this group were 76.3％ 、40.2％ respectively. Conclusion Primary small intestinal tumour was main adenocarcinoma, but stromal tumour has become the second high incidence of small bowel tumours. Joint use of variety of inspection techniques can improve the diagnostic rate. Surgical treatment is the principal therapy of primary small bowel tumour, and it is beneficial that choose sensitive adjuvant therapy according to pathologic type.
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