本文關(guān)鍵詞：以十二指腸球部潰瘍?yōu)楸憩F(xiàn)的淋巴瘤：3例報告和文獻(xiàn)復(fù)習(xí)　出處：《浙江大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 十二指腸球部潰瘍 非霍奇金淋巴瘤 難治性消化性潰瘍 克羅恩病 嗜酸性粒細(xì)胞胃腸病 卓-艾綜合征 十二指腸結(jié)核 十二指腸腺癌

【摘要】：1、背景和目的 消化性潰瘍是臨床上的常見疾病,其中十二指腸球部潰瘍(DU)一般是以良性病變?yōu)橹?臨床治療后大部分都能得到改善。但有部分DU在常規(guī)治療后未能得到改善,這時需警惕以十二指腸球部潰瘍?yōu)楸憩F(xiàn)的少見疾病。本文對十二指腸內(nèi)球部潰瘍表現(xiàn)的少見疾病進(jìn)行鑒別診斷,并通過3例在我院診治的和國內(nèi)報道的類似的10例病例總計13例的十二指腸球部潰瘍表現(xiàn)的淋巴瘤進(jìn)行分析,提高對十二指腸球部潰瘍表現(xiàn)的少見疾病尤其是淋巴瘤的認(rèn)識和診治水平。 2、方法 對2006-2015年間我院診治的3例以十二指腸球部潰瘍?yōu)楸憩F(xiàn)的淋巴瘤和國內(nèi)近20年報道的10例相似病例進(jìn)行歸納總結(jié),并對以十二指腸潰瘍表現(xiàn)的少見疾病如克羅恩病、結(jié)核病、腺癌、嗜酸性粒細(xì)胞性胃腸炎、Z ollinger Ellison綜合癥進(jìn)行鑒別診斷。 3、結(jié)果 13例患者中,男性8例,占61.5%(8/13),女性5例,占38.5%(5/13),年齡最小25歲,最大年齡77歲,平均年齡為50+27歲,中位年齡為52歲。13例患者主訴中,10例患者均有腹部不適或疼痛,其中40%(4/10)訴與進(jìn)食相關(guān)；3例患者主訴中有黑便,2例主訴有嘔血。13例患者胃鏡檢查中均有十二指腸球部潰瘍表現(xiàn)。13例病人病理診斷中,明確診斷為DLBCL有7例；3例報道指出是B型非霍奇金淋巴瘤,未進(jìn)行明確分類；1例指出是NHL未進(jìn)行具體報告,1例為小B細(xì)胞淋巴瘤,1例為霍奇金淋巴瘤。治療方面其中6例單純行化療,6例單純行手術(shù)治療,1例行手術(shù)后放化療。 4、結(jié)論 十二指腸球部潰瘍是最常見的消化道潰瘍,但是有一部分以十二指腸球部潰瘍?yōu)楸憩F(xiàn)的少見疾病在臨床上需要加強(qiáng)警惕和認(rèn)識。 十二指腸球部潰瘍?yōu)楸憩F(xiàn)的淋巴瘤早期診斷的關(guān)鍵在于藥物治療后的復(fù)查和足夠的警惕性,內(nèi)鏡下或超聲胃鏡下活檢是其主要確診手段；病理類型以彌漫大B細(xì)胞淋巴瘤為主,目前手術(shù)治療結(jié)合化療是主要的治療方法。
[Abstract]:1, background and purpose
Peptic ulcer is a common clinical disease, including duodenal ulcer (DU) in general is a benign lesion, most clinical treatment can be improved. But there are some DU failed to improve in the routine treatment, then need to be alert for rare disease manifestations in duodenal ulcer. This rare disease of duodenum in the differential diagnosis of duodenal ulcer, and through 3 cases in our hospital and reported similar total 10 cases of duodenal ulcer manifestation in 13 cases of lymphoma were analyzed, the performance of the twelve refers to a rare disease of intestinal ulcer especially is diagnosis and therapy of lymphoma.
2, method
During the period of 2006-2015 in our hospital for diagnosis and treatment of 3 cases with duodenal ulcer as a manifestation of lymphoma and the recent 20 years in China reported 10 cases of similar cases are summarized, and the rare disease with duodenal ulcer manifestations such as Crohn's disease, tuberculosis, cancer, eosinophilic gastroenteritis, Z ollinger syndrome Ellison differential diagnosis.
3, the result
In 13 patients, 8 cases were male, accounting for 61.5% (8/13), 5 cases of women, accounting for 38.5% (5/13), the youngest 25 years old, the maximum age of 77 years old, the average age was 50+27 years old, the median age was 52 years old.13 patients complained, 10 patients had abdominal pain or discomfort, which 40% v. (4/10) associated with eating; 3 patients complained of melena, 2 cases complained of hematemesis.13 patients in gastroscopy were duodenal ulcer patients showed.13 pathological diagnosis, diagnosed as DLBCL 7 cases; 3 cases reported that B non Hodgkin's lymphoma is not clear classification; 1 cases of pointed out that NHL is not specific report, 1 cases of small B cell lymphoma, 1 cases of Hodgkin lymphoma. The treatment including 6 cases underwent chemotherapy, 6 cases underwent surgical treatment, 1 cases underwent chemotherapy after surgery.
4. Conclusion
Duodenal ulcer is the most common digestive tract ulcer, but some rare diseases characterized by duodenal bulb ulcer need to be vigilant and recognized clinically.
The key to early diagnosis of lymphoma of the duodenal ulcer is drug treatment after review and sufficient vigilance, or endoscopic biopsy under ultrasonic gastroscopy is the main means of diagnosis; pathological types of diffuse large B cell lymphoma, surgical treatment combined with chemotherapy is the main treatment method.

【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R573.1;R735.31

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本文編號：1362211