腹膜假性粘液瘤8例诊治体会  

Pseudomyxoma peritonei:Report of 8 cases

作　　者：艾克热木.玉苏甫[1] 帕尔哈提.沙依木 艾孜买提.热合木吐拉[1] 王海江[1] 

机构地区：[1]新疆医科大学附属肿瘤医院胃肠外科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2011年第6期616-618,共3页Journal of Xinjiang Medical University

摘　　要：目的 探讨腹膜假性粘液瘤的临床病理特征和诊疗经验。方法回顾性分析8例腹膜假性粘液瘤患者的临床资料。8例患者主要以腹胀、腹部包块为主诉,术前超声检查提示不均质肿块及腹水,腹部CT提示腹水、肝肾脾多发囊性占位,腹膜不均匀增厚,5例查癌胚抗原(CEA)不同程度升高。所有患者均经手术治疗,手术包括切除原发病灶、网膜或其它脏器及尽可能清除粘液性病变组织,无手术死亡及严重并发症发生。辅助治疗包括腹腔热疗、腹腔局部及全身化疗。结果术后病理证实4例来自阑尾粘液囊腺瘤或腺癌,2例来自卵巢粘液囊腺瘤,2例来源不明。术后随访率100%(8/8),1年存活率87.5%(7/8),3年存活率75%(6/8),5年存活率50%(4/8)。结论腹膜假性粘液瘤术前诊断很困难,B超、CT和CEA检查对其诊断可能有帮助。反复侵袭性手术并辅以腹腔热疗、化疗能明显提高生存率。Objective To discuss the clinicopathologic characters and therapeutic experience of pseudomyxoma peritonei（PMP）.Methods Retrospective study was made on 8 cases of PMP treated in our department and review the literature.Results Main clinical presentations included abdominal distention,ascites,mass,pain and wasting.Ultrasonography showed heterogeneous ascites and masses.Abdomen CT scan showed multiple cystic lesions around liver,kidney and spleen,nonuniform peritoneal thickening,different degree of CEA rising can be found in 5 cases.All patients underwent surgery.Primary tumour was identified in appendix of 4 cases,in ovary of 2 case and unidentified in 2 cases.Surgical procedure included resection of primary tumor,omentum,removal of mucinous ascites and combined resection of organs involved.Adjuvant therapy included intra abdominal thermal therapy,local chemotherapy and postoperative chemotherapy.All patients were followed-up and 1-year survival was 7 cases,3-year survival was 6 cases and 5-year survival was 4 cases.Conclusion PMP is a rare condition and difficult to be diagnosed before surgery.Ultrasonography,CT and CEA may help in making diagnosis.Being a low-grade malignant and infrequent metastasis,PMP is often responsive to repeated debulking followed by adjuvant therapy,hence has a favorable long-term survival.

关 键 词：腹膜假粘液瘤 诊断 综合疗法 

分 类 号：R735.5[医药卫生—肿瘤]