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小肠肿瘤临床少见,良性肿瘤以息肉、平滑肌瘤、腺瘤、脂肪瘤等为主;恶性肿瘤则有腺癌、淋巴瘤、平滑肌肉瘤及类癌,其发病率远较良性肿瘤为低,但诊断不易、预后较差。我科自1998年2月共收治的小肠平滑肌肉瘤23例,就其临床特点、诊断及治疗等分析报告如下: 1 临床资料 1.1 一般资料 本组小肠平滑肌肉瘤23例中,男13例,女性10例;年龄自18～79岁,平均46.8岁,其中<30岁者1例,30～59岁者18例,>60岁者4例。其临床诊断均经手术及病理证实。 1.2 临床表现 腹痛15例(65.2％),以隐痛、胀痛不适为主,出现急腹痛、全腹压痛、肌紧张,表现为弥漫性腹膜炎1例;腹痛伴腹胀、呕吐,术中证实为肠套迭2例。腹部包块13例(56.5％),常为患者自行发现,肿块自鸭蛋到儿头大小,以脐周及下腹多见,边界较清楚,常可推动,一侧下腹包块误诊为肿瘤卵巢。贫血较常见,血色素低于100g/L者14例(60.9％),最低仅46g/L。病程中有黑粪者9例(39.1％),间歇发作,病程在2周～6年,严重时可有心悸、眩晕。1例肠套迭患者有粘液血便。病程中有呕血者1例系十二指肠平滑肌肉瘤。全组2例有发热,体温在38℃～39℃,明显消瘦者2例。
Small intestinal tumors are rare, benign tumors with polyps, leiomyomas, adenomas, lipomas, etc .; malignant tumors are adenocarcinoma, lymphoma, leiomyosarcoma and carcinoid, the incidence is much lower than benign tumors, but Diagnosis is not easy, the prognosis is poor. Our department since February 1998 were treated 23 cases of small bowel leiomyosarcoma, its clinical features, diagnosis and treatment analysis reports are as follows: 1 Clinical data 1.1 General Information The group of 23 cases of small bowel leiomyosarcoma, 13 males and 10 females Cases; age from 18 to 79 years old, average 46.8 years, of which <30 years old in one case, 30 to 59 years old in 18 cases,> 60 years old in 4 cases. The clinical diagnosis was confirmed by surgery and pathology. 1.2 Clinical manifestations of abdominal pain in 15 cases (65.2%), to pain, pain and discomfort, the emergence of acute abdominal pain, abdominal tenderness, muscle tension, manifested as diffuse peritonitis in 1 case; abdominal pain with abdominal distension and vomiting, confirmed by surgery Set of Diego 2 cases. Abdominal mass in 13 cases (56.5%), often found by patients themselves, the size of the tumor from the duck to the head, more common in the umbilical cord and lower abdomen, the border is more clear, and can often promote the side of the lower abdominal mass misdiagnosed as tumor ovarian. Anemia is more common, hemoglobin less than 100g / L in 14 cases (60.9%), the lowest only 46g / L. During the course of the disease, there were 9 cases (39.1%) of black dung, intermittent attack, duration of 2 weeks to 6 years, severe may have palpitations, dizziness. 1 case of intestinal intussusception patients have mucus bloody stool. Course of hematemesis in a case of Department of duodenal leiomyosarcoma. The whole group of 2 patients had fever, body temperature at 38 ℃ ~ 39 ℃, 2 patients were significantly weight loss.