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目的研究十二指肠Brunner腺瘤的临床特征和诊治进展。方法总结分析15例十二指肠Brunner腺瘤患者的临床表现、血清学检测、X线钡餐造影、普通内镜、超声内镜检查和治疗结果。将部分接受超声内镜检查者的诊断结果与术后组织病理检查结果进行对比。结果15例患者中有症状和体征者8例,其中伴发溃疡4例(溃疡并发穿孔2例),并发上消化道出血4例。所有患者血清学检查无异常；接受X线钡餐造影6例,内镜检查13例,诊断十二指肠Brunner腺瘤仅2例；超声内镜检查8例,均诊断为十二指肠Brunner腺瘤。15例患者中采用外科手术治疗7例,内镜摘除治疗8例,术前超声内镜检查结果与术后组织病理学诊断一致。结论十二指肠Brunner腺瘤是一种良性肿瘤,临床表现缺乏特异性,超声内镜检查对该病的诊治有一定价值,外科手术或内镜下摘除是主要的治疗方法。
Objective To study the clinical characteristics and diagnosis and treatment of duodenal Brunner’s adenoma. Methods The clinical manifestations, serological test, X-ray barium meal radiography, general endoscopy, endoscopic ultrasonography and treatment of 15 cases of duodenal Brunner’s adenoma were analyzed. Some patients who underwent endoscopic ultrasonography were compared with postoperative histopathological findings. Results Among the 15 patients, 8 had symptoms and signs, including 4 with ulcer (2 with ulcer complicated perforation) and 4 with upper gastrointestinal bleeding. All patients had no abnormalities in serology. Six patients underwent X-ray barium angiography, 13 were diagnosed by endoscopy, two were diagnosed as Brunner’s adenoma of duodenum. Eight were diagnosed by ultrasound endoscopy, which were diagnosed as Brunner’s duodenum tumor. Among the 15 patients, 7 cases were treated with surgery and 8 cases were treated with endoscopic removal. The results of preoperative ultrasound and endoscopy were consistent with the histopathological diagnosis. Conclusions Duodenal Brunner’s adenoma is a benign tumor, its clinical manifestations are lack of specificity. EUS is valuable for the diagnosis and treatment of this disease. Surgical or endoscopic removal is the main treatment.