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本文报告我院1963年至1993年30年间收治的原发性小肠肿瘤60例,其中腺癌38例,占63%,平滑肌肉瘤11例、占18%;淋巴肉瘤8例,占13%;脂肪肉瘤3例,占5%。病变部位依次为:小肠占79%,12指肠占21%,因小肠肿瘤发病率低,临床症状不典型,缺乏有效的诊断手段,误诊率高达65~100%。多数病人因延误诊断治疗,预后极差。本文分析了误诊原因,为提高早期诊断,减少误诊,提高治愈率,认为临床医师应提高警惕,全面掌握和分析临床症状与资料。对40岁以上有不明原因的腹痛、消瘦、贫血,消化吸收功能紊乱,腹块等均应进行相应的检查,如双重气钡消化道造影,大便隐血试验,B超,CT,血管造影等。对无阳性发现者,在可能情况下应及时手术探查。
This article reports 60 cases of primary small bowel tumors treated in our hospital from 1963 to 1993, including 38 adenocarcinomas, accounting for 63%, 11 cases of leiomyosarcoma, accounting for 18%; 8 cases of lymphosarcoma, accounting for 13%; Sarcoma occurred in 3 cases, accounting for 5%. The pathological changes were as follows: small intestine accounted for 79%, and 12 intestine accounted for 21%. Due to the low incidence of small intestine tumors, clinical symptoms are not typical, and lack of effective diagnostic tools, the rate of misdiagnosis is as high as 65 to 100%. Most patients have poor prognosis because of delay in diagnosis and treatment. This article analyzes the reasons for misdiagnosis, in order to improve early diagnosis, reduce misdiagnosis, and improve the cure rate, believe that clinicians should be vigilant to fully grasp and analyze clinical symptoms and data. For those who are over 40 with unexplained abdominal pain, weight loss, anemia, digestive and absorptive functions, and abdominal masses, etc. should be examined accordingly, such as double gastroenteric angiography, fecal occult blood test, B-ultrasonography, CT, and angiography. For those who do not have positive findings, surgical exploration should be performed promptly if possible.