摘要
目的 :通过胸膜间皮瘤的病因及临床表现的研究 ,从而提高诊断和治疗水平。方法 :选择 2 2例胸膜间皮瘤病人均行手术治疗 ,其中胸膜部分剥脱及肿瘤切除 9例、肺叶切除 3例、肺楔形切除肿瘤 3例、肺叶切除加胸膜部分切除 2例、胸膜全肺切除2例、瘤体巨大突入腹腔行姑息性切除 1例。年龄 40岁以上 ,男性 ,临床上有胸痛、气短、咳嗽、咯血丝痰、发热 ,胸廓变形 ,呼吸音减弱或消失 ,胸部X线、CT、MRI检查可了解瘤体的大小与周围组织及器官的关系 ,胸穿活检、胸腔镜检对本病有较高的诊断价值。本组良性胸膜间皮瘤占 3 6% ,恶性占 64 %。结果 :全组病人均无石棉接触史 ,确诊率为 3 6% ,术后随访率 81 8% (18/ 2 2 ) ,术后 1～ 2年的生存率分别 5 0 %和 2 5 %。结论 :胸膜间皮瘤的病因除了石棉接触史 ,可能与肺纤维化、胸部外伤或继发其他原因的胸膜疾患有关。良性胸膜间皮瘤手术治疗预后好 ,局限型恶性胸间皮瘤必须进行切除彻底、术后行放疗和化疗 ,弥漫性恶性胸膜间皮瘤预后不佳。
Objective:To improve the level of diagnosis and treatment in this disease by studying the etiopathogenesis and clinical symptoms of pleural mesothelioma.Methods:22 patients with pleural mesothelioma were selected to undergo surgical treatment.Complete removal of tumor and partial strippling of the pleural were carried out in 9 patients,pulmonary lobectomy in 3 patients,wedge-shape excision of lung in 3 patients,pulmonary lobectomy and pleurectomy in 2 patients,total pleuropneumonectomy in 2 patients and one patient underwent palliative excision of huge mass for invasion into the abdominal cavity.Results:All patients in the group had no contact history with asbestos.Confirmed diagnosis rate was 36%,postoperative follow-up rate was 81.8%(18/20),one year and two years postoperative rate was 50% and 25% respectively.Conclusion:The etiopatho genesis of pleural mesothelioma may be related to pulmonary fibrosis,chest injury or secondary cause of pleural disease besides of contact history with asbestos.Surgical treatment of benign pleural mesothelioma has a favourable prognosis,local malignant pleural mesothelioma must be excised radically and associate with postoperative radiotherapy and chemotherapy,and diffuse malignant pleural mesothelioma has an unfavourable prognosis. [
出处
《内蒙古医学杂志》
2000年第5期334-345,共12页
Inner Mongolia Medical Journal
