腹膜假性粘液瘤的诊断及治疗

Diagnosis and treatment of pseudomyxoma peritonei

探讨腹膜假性粘液瘤的诊断及治疗方法，并回顾有关文献。对北京协和医院１９８３～１９９８年收治并确诊 的１７例腹膜假性粘液瘤病例进行回顾性分析研究。结果：１７例患者中，男性１例，女性１６例。年龄２０～７１岁， 平均５２岁。１７例患者中，１４例伴卵巢粘液性囊腺瘤，其中４例合并阑尾粘液囊肿。１７例患者中包括１例卵 巢浆液性囊腺瘤，１例卵巢粘液腺癌，１例男性阑尾粘液囊肿。所有病人均经手术治疗１～６次，平均每人２．５次。 ２次手术间隔７个月～７年４个月，平均３．６年。术后１年内死亡３例。结论：尽管腹膜假性粘液瘤被认为是一 种分化较好的低度恶性或交界性肿瘤，但复发是极常见的现象，远处转移几乎不存在。其来源最多见于卵巢 和阑尾。外科手术切除仍是目前最有效的治疗手段。

To review the experience of diagnosis and treatment for pseudomyxoma peritonei. Seventeen patients were treated for pseudomyxoma peritonei at Peking Union Medical College Hospital between 1983 and 1998, all charts and clinical data were reviewed. Results:The mean age at diagnosis was 52 years(range 20-71 ). Sixteen out of seventeen patients had the ovarian mucinous tumors which were bilateral in 8 cases, and one man had appendiceal mucinous tumor. All patients underwent cytoreduction. Eight patients received postoperative therapy. All 17 patients developed a recurrence. Thirteen patients required at least one additional laparotomy because of accumulation of gelatinous material. Conclusion:Although pseudomyxoma peritonei is associated with borderline and well-differentiated tumors, recurrence is common. To date, surgery has been the only effective therapy for this disease, and adjuvant therapy has not been shown conclusively to be of benefit.