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目的:探讨胃肠道间质瘤(GIST)的诊断、治疗经验。方法:回顾性分析2000年12月-2005年12月收治的58例GIST的临床资料。结果:消化道出血28例,腹部疼痛不适19例,无症状体检时发现9例,肠梗阻2例。B超检查发现腹腔肿物23例,CT发现肿瘤30例,8例上消化道造影提示胃肿瘤,胃镜检查发现肿瘤10例,病理检查均未确诊间质瘤。因间质瘤术后复发再入院3例。肿瘤位于胃38例,小肠15例,肠系膜及大网膜4例,结肠1例。58例均行手术,其中远端胃大部切除19例,近端胃大部切除5例,胃局部切除14例;小肠切除吻合15例;大网膜切除3例;肠系膜肿物切除1例;右半结肠切除1例。结论:GIST多发于中老年,以消化道出血、腹痛为主要症状。术前难以确诊,体检、B超和CT对诊断有重要意义。治疗以手术为主,可局部切除。术后复发可再手术治愈。口服甲磺酸伊码替尼对姑息切除者仍有效。
Objective: To investigate the diagnosis and treatment of gastrointestinal stromal tumors (GISTs). Methods: The clinical data of 58 patients with GIST admitted from December 2000 to December 2005 were retrospectively analyzed. Results: There were 28 cases of gastrointestinal bleeding, 19 cases of abdominal pain and discomfort, 9 cases of asymptomatic physical examination and 2 cases of intestinal obstruction. B-ultrasound examination found that 23 cases of abdominal tumor, CT found 30 cases of tumor, 8 cases of upper gastrointestinal carcinoid tumor prompted gastric biopsies found in 10 cases of tumor, pathological examination were not diagnosed stromal tumors. Three cases were admitted to hospital because of stromal tumor recurrence. Tumor located in 38 cases of stomach, small intestine in 15 cases, mesenteric and omental in 4 cases, 1 case of colon. Fifty-eight cases underwent radical gastrectomy, including distal gastrectomy in 19 cases, proximal gastrectomy in 5 cases, partial gastrectomy in 14 cases, small intestine resection and anastomosis in 15 cases, omentum resection in 3 cases, mesenteric tumor in 1 case Right colon resection in 1 case. Conclusion: GIST mainly occurs in middle-aged and elderly people. Gastrointestinal bleeding and abdominal pain are the main symptoms. Difficult to diagnose preoperative, physical examination, B ultrasound and CT have important significance in the diagnosis. The main treatment for surgery, partial excision. Recurrence can be cured after surgery. Oxytetracycline mesylate is still effective for palliative resection.