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学科主题: 外科学
题名:
130例原发性十二指肠肿瘤的临床分析
其他题名: Clinical analysis on 130 cases of primary tumor of the duodenum
作者: 陈宁; 张同琳
关键词: 十二指肠肿瘤 ; 胰十二指肠切除术 ; 诊断 ; Duodenal neoplasms ; Pancreaticoduodenectomy ; Diagnosis
刊名: 中华普通外科杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.1007-631X.2012.09.001
卷: 27, 期:9, 页:697-700
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 总结原发性十二指肠肿瘤的临床特点,探讨早期诊断及选择合理的治疗方法.方法 回顾性分析北京大学第三医院1974-2010年间收治的130例原发性十二指肠肿瘤的临床资料,其中良性30例,恶性100例.结果 本组原发性十二指肠肿瘤主要位于十二指肠球部和降部,占全部肿瘤的90%以上,恶性肿瘤中59%位于乳头部.良性肿瘤平均直径在2 cm以下,而恶性肿瘤直径多在3 ~5 cm或以上.上腹痛、黄疸、黑便、腹部包块及十二指肠梗阻症状为原发性十二指肠肿瘤的常见临床表现,黄疸是乳头部肿瘤的主要表现,胃肠道梗阻和腹部包块多提示较晚期肿瘤.十二指肠镜联合气钡双重X线造影是诊断该部位肿瘤的重要检查手段.30例原发性十二指肠良性肿瘤中,11例行肿瘤局部切除术,14例行内镜下肿瘤切除术,3例行胰十二指肠切除术,切除率100%,术后5年生存率为100%;100例原发性十二指肠恶性肿瘤中,56例行标准的胰十二指肠切除术,包括3例行保留幽门的胰十二指肠切除术,9例行肿物局部切除术,12例行十二指肠节段切除术,切除率为84%.59例胰十二指肠切除术后5年生存率为46%. 结论 原发性十二指肠肿瘤缺乏特异性临床表现,对可疑病例及时行内镜、气钡X线造影等联合检查可提高术前阳性诊断率.对良性肿瘤可行十二指肠节段切除或局部切除术,恶性肿瘤首选胰十二指肠切除术. Objective To investigate the clinical features,early diagnosis and therapeutic methods of primary tumor of the duodenum. Methods The clinical data of 130 patients of primary tumor of the duodenum who were hospitalized in Peaking University Third Hospital from 1974 to 2010 were summarized.There were 30 cases of benign tumors and 100 cases of malignancy. Results More than 90% of primary tumors of the duodenum were located at the duodenal bulb and descendent part.59% of malignant tumors were located in the area of duodenal papilla. The mean diameter of benign tumors was less than 2 cm compared with more than 3 cm in malignancies. Upper abdominal pain,jaundice,black stool,intestinal obstruction and abdominal mass were among the most common clinical manifestations. Jaudice was most common in papilla tumors,and intestinal obstruction and palpable abdominal mass often indicate advanced stage.Duodenofiberscopy combined with air barium double contrast radiography increase the diagnosis rate.Among the 30 benign cases,11 cases underwent simple tumor resection,14 cases received endoscopic tumor resection and 3 cases underwent pancreaticoduodenectomy.Resection rate and the 5-year survival rate was 100%. Of the 100 malignant cases,56 cases underwent standard pancreaticoduodenectomy,3 cases received pylorus preserving pancreaticoduodenectomy,9 cases underwent simple tumor resection and 12 cases received segmental duodenectomy.Resection rate was 84%.The 5-year survival rate was 46% in 59 cases receiving Whipple's procedure. Conclusions Primary tumor of the duodenum lacks specific clinical features. Simple tumor resection and segmental duodenectomy can be done for benign cases, while pancreaticoduodenectomy is the therapy of choice for malignant cases.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/73188
Appears in Collections:北京大学第三临床医学院_普通外科_期刊论文

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作者单位: 100191,北京大学第三医院普通外科

Recommended Citation:
陈宁,张同琳. 130例原发性十二指肠肿瘤的临床分析[J]. 中华普通外科杂志,2012,27(9):697-700.
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