中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2015年
3期
252-253
,共2页
十二指肠间质瘤%诊断%治疗
十二指腸間質瘤%診斷%治療
십이지장간질류%진단%치료
Duodenal gastrointestinal stromal tumor%Diagnosis%Treatment
目的：探讨十二指肠间质瘤的临床特点、诊疗方法。方法：14例十二指肠GIST患者，男性8例，女性6例；年龄33～72岁，平均年龄55.3岁。14例患者中8例有反复柏油便，6例有餐后饱胀感、反酸嗳气，6例有腹痛、上腹部不适，4例有腹部包块。病变部位：降部12例，球部2例。对14例患者的临床资料进行回顾性分析。结果：14例十二指肠GIST患者以消化道出血、上腹部疼痛不适、腹部包块为常见症状，发病部位以降部多见，CT及胃镜检出率均为100%，均行手术治疗。肿瘤局部切除术8例，十二指肠节段切除术4例，胰十二指肠切除术2例。围手术期无患者死亡。10例患者术后服用格列卫治疗。14例患者随访25月～10年，1例于术后11个月复发并出现腹腔转移，并于术后25个月死亡，13例患者随访期内均未发现复发，生活质量佳。结论：十二指肠GIST缺乏特异性的临床表现，综合应用内镜及影像学检查有助于提高术前检出率，确诊主要依靠病理组织学检查及免疫组化检测。治疗方法为手术治疗与分子靶向治疗结合的个性化综合治疗。
目的：探討十二指腸間質瘤的臨床特點、診療方法。方法：14例十二指腸GIST患者，男性8例，女性6例；年齡33～72歲，平均年齡55.3歲。14例患者中8例有反複柏油便，6例有餐後飽脹感、反痠噯氣，6例有腹痛、上腹部不適，4例有腹部包塊。病變部位：降部12例，毬部2例。對14例患者的臨床資料進行迴顧性分析。結果：14例十二指腸GIST患者以消化道齣血、上腹部疼痛不適、腹部包塊為常見癥狀，髮病部位以降部多見，CT及胃鏡檢齣率均為100%，均行手術治療。腫瘤跼部切除術8例，十二指腸節段切除術4例，胰十二指腸切除術2例。圍手術期無患者死亡。10例患者術後服用格列衛治療。14例患者隨訪25月～10年，1例于術後11箇月複髮併齣現腹腔轉移，併于術後25箇月死亡，13例患者隨訪期內均未髮現複髮，生活質量佳。結論：十二指腸GIST缺乏特異性的臨床錶現，綜閤應用內鏡及影像學檢查有助于提高術前檢齣率，確診主要依靠病理組織學檢查及免疫組化檢測。治療方法為手術治療與分子靶嚮治療結閤的箇性化綜閤治療。
목적：탐토십이지장간질류적림상특점、진료방법。방법：14례십이지장GIST환자，남성8례，녀성6례；년령33～72세，평균년령55.3세。14례환자중8례유반복백유편，6례유찬후포창감、반산애기，6례유복통、상복부불괄，4례유복부포괴。병변부위：강부12례，구부2례。대14례환자적림상자료진행회고성분석。결과：14례십이지장GIST환자이소화도출혈、상복부동통불괄、복부포괴위상견증상，발병부위이강부다견，CT급위경검출솔균위100%，균행수술치료。종류국부절제술8례，십이지장절단절제술4례，이십이지장절제술2례。위수술기무환자사망。10례환자술후복용격렬위치료。14례환자수방25월～10년，1례우술후11개월복발병출현복강전이，병우술후25개월사망，13례환자수방기내균미발현복발，생활질량가。결론：십이지장GIST결핍특이성적림상표현，종합응용내경급영상학검사유조우제고술전검출솔，학진주요의고병리조직학검사급면역조화검측。치료방법위수술치료여분자파향치료결합적개성화종합치료。
Objective: To investigate the clinical features,diagnosis and treatment of duodenal gastrointestinal stromal tumors(GIST). Methods:14 cases of patients with duodenal GIST,8 cases of male,6 cases of female; the age is 33~72 years old,the average age is 55.3 years old. In 14 patients,8 patients had recurrent tarry stool,6 cases had postprandial fullness,acid regurgitation and belching,6 cases with abdominal pain,abdominal discomfort,4 cases of abdominal mass. The lesion: the descending portion of the 12 cases,2 cases located in duodenal bulb. The clinical data of 14 cases were retrospectively analyzed.Results:14 cases with gastrointestinal bleeding,abdominal pain and discomfort,abdominal mass were the common symptoms,onset location in the descending portion of rare,CT and endoscopic detection rate was 100%,were treated by operation. Local tumor resection in 8 cases,4 cases of resection of duodenal segmental resection,pancreato duodenectomy in 2 cases. No patients died peri operation period. 10 patients taking Gleevec therapy. 14 patients were followed up for 25 months to 10 years,1 cases of postoperative recurrence in 11 months and the emergence of peritoneal metastasis,and died 25 months after operation,13 patients were followed up period were found no recurrence,the quality of life better.Conclusion:The clinical manifestation of duodenal GIST is lack of specificity,the comprehensive application of endoscopic and imaging examination is helpful to improve the preoperative diagnostic rate,the diagnosis relies mainly on histopathological and immunohistochemical detection. Individualized comprehensive treatment method for the surgical treatment of molecular targeted therapy and combination.
