腹膜假性粘液瘤10例临床分析

Diagnosis and treatment of pseudomyxoma peritonei: report of 8 cases

目的 :探讨腹膜假性粘液瘤的诊断和治疗方法。方法 :回顾性分析 10例腹膜假性粘液瘤的诊治经验。结果 :B超和CT检查均提示腹部包块呈不均质囊性和 (或 )不均质腹水。术前 8例患者行腹部包块和 (或 )腹水穿刺 ,抽出胶冻状液。所有患者均行手术治疗 ,病理证实 8例肿瘤来自阑尾。 3例行根治性切除术 ,7例行肿瘤细胞减积术 ;3例术后辅予化学治疗。本组病人 3年存活率 70 % (7/ 10 ) ,5年存活率 4 0 % (4/ 10 )。结论 :腹膜假性粘液瘤术前诊断较为困难 ,腹腔穿刺抽出胶样液应首先考虑该病的可能性 ,B超和CT对诊断亦有帮助。根治性切除是治愈该病的关键。反复侵袭性切除并辅以放疗或化疗能明显提高生存率。

Objective: To investigate the diagnosis and treatment of pseudomyxoma peritonei (PMP). Methods: The clinical data of 10 cases of PMP was analysed retrospectively. Results: B-ultrasonography and CT showed that abdominal cyst and/or ascites were heterogeneous in all patients. Mucilaginous fluid was drawn out of abdominal mass and/or ascites by abdominocentesis in 8 cases. All patients underwent surgery. PMP stemed from appendix in 8 cases. Cruative resection in 3 cases, cytoreductive surgery in 7 cases. Postoperative adjuvant chemotherapy was added to 3 cases. All patients were followed-up and 3-year surrival rate was 70% (7/10), 5-year surrival rate was 40% (4/10). Conclusion: PMP is difficult to diagnosis before surgery, PMP is considered the first diagnosis when mucilaginous fluid was drawn out. B-ultrasonography and CT were good for diagnosis. Curative resection is the only hope of cure, repeated debulking followed by adjuvant therapy has a long-term survival.