原发性十二指肠癌43例临床研究.doc

原发性十二指肠癌43例临床研究[摘要] 目的：探讨原发性十二指肠癌的临床特点、诊断、治疗方法，为早期诊治提供依据。方法：回顾性总结分析43例原发性十二指肠癌的临床资料。结果：43例原发性十二指肠癌中33例位于十二指肠降段，病理类型以腺癌最多见。临床表现以黄疸、腹痛或上腹不适、消化道梗阻及消化道出血为主，其中有3例并发胆肠瘘。检查方法以内镜结合病理检查再配合胃肠钡餐造影为主。外科手术是本病的主要治疗手段。结论：原发性十二指肠癌的预后差，早期诊断的关键是提高对本病的认识，对可疑患者及时行相应检查可提高诊断率。 [关键词] 十二指肠癌；临床分析 [中图分类号]R735.3+1 [文献标识码]C [文章编号]1673-7210（2008）03（c）-166-02 Clinical analysis of 43 cases with primary duodenal carcinoma LIU Yun-feng (Department of Oncology, Yongzhou People’s Hospital of Hunan Provice, Yongzhou 425006, China) [Abstract] Objective:To study the clinical manifestation, diagnostic methods and treatment of primary duodenal carcino-ma, in order to provide reliable message for early diagnosis and treatment.Methods:The records of 43 patients with primary duodenal carcinoma were retrospectively analyzed.Results:In 43 primary duodenal carcinomas,33 located in the down section of the duodenum, the adenocarcinoma was more common in all pathologie types.The prominent clinical manifestations were jaun-dice abdomen pains or epigestria discomfort, obstruction and hemorrhage of digestive tract,3 patients were complicated by duodenocholangio fistulas.The main diagnostic procedures were endoscopic,upper GI barium meal,combined with pathologic diagnosis.Surgery was the main method of treatment for this carcinoma.Conclusion: The prognosis of the primary duodenal carcinoma is very poor,the understanding of duodenal carcinoma is the key factor for early diagnosis.The appropriate examinations are neeessary for suspected patients,and it will enhance the rate of early diagnosis. [Key words] Duodenum neoplasm;Clinical analysis 原发性十二指肠癌临床较少见，因起病隐匿，缺乏典型的临床表现，使该病的诊治有一定难度。我科2001~2006年共收治该类患者43例（不包括壶腹周围癌），现根据其临床资料进行回顾性分析，以提高对本病的早期诊断及治疗效果。 1 临床资料 1.1 一般资料 本组43例中，男性23例，女性20例；年龄29~82岁，平均56岁，其中50~80岁占70%；病程20 d~3年，平均2个月，多于出现症状后2~3个月就诊。 1.2 肿瘤部位及病理类型 本组43例均经病理检查确诊，肿瘤分布及类型见表1。 1.3 各段临床特点、并发症 见表2。 1.4 实验室检查 胆红素升高[TB (85.6±6.2) μmol/L，DB (49.4±5.3) μmol/L]30例，AKP升高30例，