以肠套叠为入院诊断的小肠肿瘤21例临床分析(1)
【摘要】 目的 研究分析臨床中以肠套叠为入院诊断的小肠肿瘤患者的临床表现、诊断及其治疗方法。方法 回顾性分析以肠套叠为入院诊断的21例小肠肿瘤患者的临床资料。结果 本组资料中有20例患者行腹部增强CT检查， 其中19例患者结果诊断肠套叠， 1例结果提示“小肠内强化结节， 血管畸形”。该21例患者明确诊断后均于本院行手术治疗， 其中20例患者行小肠部分切除术， 1例患者行回肠部分及右半结肠切除术。术中确诊小肠肿瘤及肠套叠， 并切除肿物送检。术后石蜡病理诊断：良性肿瘤13例， 恶性肿瘤8例， 小肠间质瘤(核分裂<5/50 HPF)5例， 小肠间质瘤(核分裂>5/50 HPF)1例， 小肠脂肪瘤3例， 小肠肉瘤样癌2例， 小肠绒毛管状腺瘤1例， 小肠神经内分泌癌1例， 小肠脂肪肉瘤2例， 小肠腺癌2例， 小肠平滑肌肉瘤1例， 小肠纤维瘤1例， 小肠原始神经外胚层肿瘤1例， 小肠炎症性肌纤维母细胞瘤1例术后给予相应患者抗肿瘤辅助治疗， 患者症状缓解。结论 以肠套叠为入院诊断的小肠肿瘤患者其临床症状主要为继发性肠套叠的相关症状， 由于临床表现缺乏典型性， 导致较易出现漏诊情况。增强CT对于诊断以肠套叠为入院诊断的小肠肿瘤有极高的临床意义。对于怀疑肠套叠的患者应积极行CT等辅助检查， 以减少漏诊、误诊。手术解除肠套叠并切除肿物后， 患者症状缓解， 恢复良好。
【关键词】 肠套叠;小肠肿瘤;临床症状;并发症;诊断
DOI：10.14163/j.cnki.11-5547/r.2019.01.014
【Abstract】 Objective To study and analyze the clinical manifestations， diagnosis and treatment of small intestine tumor patients diagnosed by intussusception in the clinic. Methods The clinical data of 21 small intestine tumor patients diagnosed by intussusception was retrospectively analyzed. Results In this group， 20 patients underwent abdominal enhanced CT examination， of which 19 patients were diagnosed as intussusception， and 1 patient was diagnosed as "small intestinal enhanced nodule， vascular malformation". 21 patients underwent surgical treatment in our hospital after definite diagnosis， of which 20 patients underwent partial small bowel resection and 1 patient underwent partial ileectomy and right colon resection. The patient was diagnosed with small intestine tumor and intussusception during surgery， and the tumor was removed for examination. Postoperative paraffin pathological diagnosis： 13 cases of benign tumors， 8 cases of malignant tumors， including 5 cases of small intestinal stromal tumor (nucleosis <5/50 HPF)， 1 case of small intestinal stromal tumor (nucleolysis >5/50 HPF)， 3 cases of small intestinal lipoma， 2 cases of small intestinal sarcomatoid carcinoma， 1 case of small intestine villus tubular adenoma 1 case of small intestinal neuroendocrine carcinoma， 2 cases of small intestinal liposarcoma， 2 cases of small intestinal adenocarcinoma， 1 case of small intestinal leiomyosarcoma， 1 case of small intestinal fibroma， 1 case of primary intestinal neuroectodermal tumor， 1 case of intestinal inflammatory myofibroblastic tumor. Patients were given corresponding anti-tumor adjuvant treatment after surgery， and the symptoms of patients were relieved. Conclusion Secondary intussusception is the main clinical symptom of small intestinal cancer patients admitted to hospital， and it is easy to miss diagnosis because of the lack of typical clinical manifestations. Enhanced CT is of great clinical significance for the diagnosis of small intestine tumors diagnosed by intussusception. For patients with suspected intussusception， CT and other auxiliary examinations should be actively performed to reduce missed diagnosis and misdiagnosis. After surgical removal of intussusception and removal of tumors， the patient’s symptoms were relieved and recovered well., http://www.100md.com(李思遥)
【关键词】 肠套叠;小肠肿瘤;临床症状;并发症;诊断
DOI：10.14163/j.cnki.11-5547/r.2019.01.014
【Abstract】 Objective To study and analyze the clinical manifestations， diagnosis and treatment of small intestine tumor patients diagnosed by intussusception in the clinic. Methods The clinical data of 21 small intestine tumor patients diagnosed by intussusception was retrospectively analyzed. Results In this group， 20 patients underwent abdominal enhanced CT examination， of which 19 patients were diagnosed as intussusception， and 1 patient was diagnosed as "small intestinal enhanced nodule， vascular malformation". 21 patients underwent surgical treatment in our hospital after definite diagnosis， of which 20 patients underwent partial small bowel resection and 1 patient underwent partial ileectomy and right colon resection. The patient was diagnosed with small intestine tumor and intussusception during surgery， and the tumor was removed for examination. Postoperative paraffin pathological diagnosis： 13 cases of benign tumors， 8 cases of malignant tumors， including 5 cases of small intestinal stromal tumor (nucleosis <5/50 HPF)， 1 case of small intestinal stromal tumor (nucleolysis >5/50 HPF)， 3 cases of small intestinal lipoma， 2 cases of small intestinal sarcomatoid carcinoma， 1 case of small intestine villus tubular adenoma 1 case of small intestinal neuroendocrine carcinoma， 2 cases of small intestinal liposarcoma， 2 cases of small intestinal adenocarcinoma， 1 case of small intestinal leiomyosarcoma， 1 case of small intestinal fibroma， 1 case of primary intestinal neuroectodermal tumor， 1 case of intestinal inflammatory myofibroblastic tumor. Patients were given corresponding anti-tumor adjuvant treatment after surgery， and the symptoms of patients were relieved. Conclusion Secondary intussusception is the main clinical symptom of small intestinal cancer patients admitted to hospital， and it is easy to miss diagnosis because of the lack of typical clinical manifestations. Enhanced CT is of great clinical significance for the diagnosis of small intestine tumors diagnosed by intussusception. For patients with suspected intussusception， CT and other auxiliary examinations should be actively performed to reduce missed diagnosis and misdiagnosis. After surgical removal of intussusception and removal of tumors， the patient’s symptoms were relieved and recovered well., http://www.100md.com(李思遥)