以貧血為首發(fā)癥狀的消化道惡性腫瘤臨床分析

萬芳

摘 ? 要：目的 ?提高以貧血為首發(fā)表現(xiàn)的消化道腫瘤的認識，避免漏診和誤診。方法 ?回顧性分析我院血液科2013年5月～2017年5月收治30例以貧血為首發(fā)表現(xiàn)的消化道惡性腫瘤患者的臨床資料，患者入院后行全面檢查，給予糾正貧血治療，明確診斷后進行普外科會診，轉(zhuǎn)入外科進一步治療。結果 ?本組以貧血為首發(fā)表現(xiàn)的30例消化道腫瘤患者中食管癌3例，胃癌9例，結腸癌15例，直腸癌3例。30例患者中10例（33.33%）患者死亡，9例（30.00%）患者手術、化療后出現(xiàn)復發(fā)、轉(zhuǎn)移，11例（36.67%）患者病情穩(wěn)定。結論 ?對不明原因的貧血，特別是中老年人男性患者，應考慮消化道腫瘤的可能，盡可能完善相關檢查，盡早明確診斷，避免誤診、漏診，延誤治療。

關鍵詞：貧血;消化道惡性腫瘤;血液科;食管癌;胃癌

中圖分類號：R735.3 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻標識碼：B ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2018.24.054

文章編號：1006-1959（2018）24-0175-03

Abstract：Objective ?To improve the understanding of digestive tract tumors with anemia as the first performance， to avoid missed diagnosis and misdiagnosis.Methods ?A retrospective analysis of the clinical data of 30 patients with digestive tract malignancies with anemia as the first manifestation of the Department of Hematology in our hospital from May 2013 to May 2017. The patients underwent a comprehensive examination after admission and were given an anemia treatment. Conduct a general surgery consultation and transfer to surgery for further treatment.Results ?In this group of 30 patients with digestive tract tumors with anemia as the first manifestation， there were 3 cases of esophageal cancer， 9 cases of gastric cancer， 15 cases of colon cancer， and 3 cases of rectal cancer. Of the 30 patients， 10（33.33%）died， 9（30.00%） had recurrence and metastasis after surgery and chemotherapy， and 11 （36.67%） patients were stable.Conclusion ?For unexplained anemia， especially in middle-aged and elderly people， the possibility of digestive tract tumors should be considered. The relevant examinations should be improved as much as possible， and the diagnosis should be confirmed as early as possible to avoid misdiagnosis， missed diagnosis and delay of treatment.

Key words：Anemia;Digestive tract malignancy;Hematology;Esophageal cancer;Gastric cancer

貧血（anemia）是臨床常見一種病癥，也是危害人類健康的常見疾病之一，其病因較為復雜，有的還較為隱蔽[1]。引起貧血的病因較多，經(jīng)貧血相關化驗及骨髓穿刺檢查，由血液系統(tǒng)疾病引起的貧血診斷相對容易，但其它原因引起的貧血，其病因診斷較困難。一方面，多數(shù)以貧血就診的患者，不愿意做進一步檢查，只想著盡快解決貧血問題;另一方面，很多患者對胃鏡、腸鏡檢查存在恐懼心理，不愿接受胃腸鏡檢查，導致部分患者延誤診治。為了提高貧血患者最終病因診斷率，提高消化道腫瘤的早診斷、早發(fā)現(xiàn)，現(xiàn)對我院2013年5月～2017年5月年住院患者中以貧血為首發(fā)癥狀的30例消化道腫瘤患者的臨床資料進行回顧性分析，現(xiàn)報道如下。……