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总结分析37例小肠平滑肌肿瘤的临床诊治资料。术前明确小肠肿瘤诊断者20例,以其并发症行急症手术确定诊断者9例,误诊者8例。全部病例均以病理确诊,包括平滑肌瘤8例、平滑肌肉瘤28例和平滑肌母细胞瘤1例。腔外型生长18例,多以腹部肿块、消化道出血就诊。腔内型生长12例,多以肠梗阻就诊。腔内-腔外型6例,壁间型1例。恶性肿瘤最长径显著大于良性肿瘤,并有发热、消瘦等恶液质表现,但二者的发病年龄差异不显著。结论认为,腔外型生长肿瘤难于早期发现,消化道检查也易于漏诊,应充分重视CT扫描、MRI和选择性血管造影检查的作用。肿瘤生长方式与其性质无关,术中冰冻病理检查多可为手术方式的选择提供依据,对肿瘤性质不明者以采取根治性手术为宜。
Summary of 37 cases of intestinal smooth muscle tumor clinical diagnosis and treatment data. Preoperative clear intestinal tumor diagnosed in 20 cases, with its complications emergency surgery to determine the diagnosis of 9 cases, 8 cases of misdiagnosis. All cases were pathologically diagnosed, including 8 cases of leiomyoma, 28 cases of leiomyosarcoma and 1 case of smooth muscle blastoma. Cavity growth in 18 cases, mostly abdominal mass, gastrointestinal bleeding clinic. Endovascular growth in 12 cases, mostly in intestinal obstruction treatment. There were 6 cases of cavity-cavity type and 1 case of wall-type. The longest diameter of malignant tumors was significantly larger than that of benign tumors, with fever, emaciation and other cachexia. However, the difference in age of onset was not significant. Conclusions: It is difficult to detect early extracavitary tumor growth, digestive tract examination is also easy to misdiagnosis, should pay full attention to the role of CT scan, MRI and selective angiography. Tumor growth has nothing to do with its nature, intraoperative frozen pathological examination can provide the basis for the choice of surgical approach, the tumor of unknown nature to take radical surgery is appropriate.