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目的总结小肠腺癌的诊治经验。方法小肠腺癌患者63例,术前胃镜、小肠镜检查确诊39例;影像学检查(胃肠造影,CT,磁共振)确诊12例,经内镜逆行胰胆管造影确诊5例;手术探查确诊7例。56例患者均行手术治疗。对患者的肿瘤分期、手术方式和生存状况进行分析。结果 63例小肠腺癌患者主要临床表现为腹痛、消化道梗阻和出血。十二指肠为高发部位。早期诊断率低,本组患者中Ⅲ期占60.32%,Ⅳ期占30.16%。63例腺癌患者总1年生存率为60.32%,总2年生存率仅39.69%,十二指肠腺癌较空、回肠腺癌患者预后差。肿瘤分期、手术方式及淋巴结转移明显影响患者术后生存。结论提高早期诊断率,根治性手术切除是小肠腺癌的临床诊治关键。
Objective To summarize the diagnosis and treatment of intestinal adenocarcinoma. Methods Sixty-three patients with small bowel adenocarcinoma were diagnosed by gastroscope and enteroscopy before operation, 12 cases were diagnosed by imaging examination (gastrointestinal imaging, CT, magnetic resonance), 5 cases were confirmed by endoscopic retrograde cholangiopancreatography 7 cases. 56 patients underwent surgical treatment. The patient’s tumor staging, surgical methods and living conditions were analyzed. Results The main clinical manifestations of 63 patients with small bowel adenocarcinoma were abdominal pain, gastrointestinal obstruction and hemorrhage. Duodenum for high incidence of sites. The early diagnosis rate is low, in this group of patients accounted for 60.32% Ⅲ, Ⅳ period accounted for 30.16%. The overall 1-year survival rate of 63 adenocarcinoma patients was 60.32%, the overall 2-year survival rate was only 39.69%, the duodenal adenocarcinoma was relatively empty, and the prognosis of patients with adenocarcinoma of the ileum was poor. Tumor staging, surgical methods and lymph node metastasis significantly affect the survival of patients. Conclusion To improve the early diagnosis rate, radical surgical resection is the key to diagnosis and treatment of small bowel adenocarcinoma.