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目的 提高胃平滑肌肿瘤的外科治疗水平。方法 回顾性总结 1986～ 2 0 0 1年间收治的胃平滑肌肿瘤 2 5例的经验。结果 术前诊断率 5 2 % (13 /2 5 ) ,手术切除率 96% (2 4/2 5 ) ,术中发现平滑肌肉瘤并发溃疡、出血及与周围组织粘连、浸润 75 % (15 /2 0 ) ,病死率 8% (2 /2 5 )。结论 胃平滑肌肿瘤病变部位多位于胃体后壁 ,以腔内型多见。腹痛 ,消化道出血 ,腹部包块是其主要临床表现。当肿瘤为分叶状 ,长径 >5cm ,浸润性生长 ,肿瘤中心出血、坏死、较大溃疡形成应视其为恶性改变。诊断本病以X线钡餐造影和胃镜检查两者联合应用 ,手术切除是本病的主要治疗方法
Objective To improve the surgical treatment of gastric smooth muscle tumors. Methods The clinical experience of 25 cases of gastric smooth muscle tumors treated between 1986 and 2001 was retrospectively reviewed. Results The preoperative diagnosis rate was 52% (13/2 5) and the surgical resection rate was 96% (2 4/2 5). The patients had leiomyosarcoma complicated with ulceration, hemorrhage and adhesions with the surrounding tissues. The invasion rate was 75% (15/2 0), mortality was 8% (2/2 5). Conclusion Most of the lesions in gastric smooth muscle tumors are located in the posterior wall of the gastric body. Abdominal pain, gastrointestinal bleeding, abdominal mass is its main clinical manifestations. When the tumor is lobulated, long diameter> 5cm, invasive growth, tumor center bleeding, necrosis, the formation of larger ulcers should be considered as malignant changes. Diagnosis of the disease to X-ray barium meal angiography and gastroscopy both combined application of surgical removal of the disease is the main treatment