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目的 总结小肠间质瘤诊断和治疗经验。方法 对1993—2 0 0 4年收治的2 0例小肠间质瘤的临床资料进行回顾性分析。结果 临床表现为黑便、果酱样血便14例、头晕9例、贫血3例,伴腹部疼痛11例,发病时间2个月至7年。确诊方式:剖腹探查12例,腹腔镜探查6例,小肠镜检查2例;手术方式:小肠间质瘤切除18例,胰十二指肠切除术1例,肿瘤无法切除行保守治疗1例。随访6个月至9年,除1例死于脑干出血、2例长期服用甲磺酸伊马替尼(Gleevec)症状部分缓解外,其余17例均健在,间质瘤无复发。结论 小肠间质瘤预后较好,但对不明原因的消化道出血应及早探查,以避免误诊;Gleevec对晚期小肠间质瘤有较好疗效
Objective To summarize the experience of diagnosis and treatment of small intestinal stromal tumors. Methods The clinical data of 20 cases of small intestinal stromal tumors admitted from 1993 to 2004 were analyzed retrospectively. Results The clinical manifestations were melena, jam-like bloody stool in 14 cases, 9 cases of dizziness, anemia in 3 cases, with abdominal pain in 11 cases, the onset time of 2 months to 7 years. Diagnostic methods: laparotomy in 12 cases, laparoscopy in 6 cases, small boweloscopy in 2 cases; operation: 18 cases of intestinal stromal tumor, pancreaticoduodenectomy in 1 case, the tumor can not be removed conservative treatment in 1 case. All the patients were followed up for 6 months to 9 years. Except for 1 case of bleeding from brain stem and 2 cases of long-term Gleevec mesylate symptom relief, the remaining 17 cases were all well-established without recurrence of stromal tumor. Conclusion The prognosis of intestinal stromal tumors is good, but unexplained gastrointestinal bleeding should be probed early to avoid misdiagnosis; Gleevec has a good effect on advanced small intestinal stromal tumors