腹膜假黏液瘤8例误诊及治疗分析

Diagnosis and treatment of pseudomyxoma peritonei in accidental discovery： a report of 8 cases

目的 总结腹膜假黏液瘤的诊治经验,为临床鉴别诊断和治疗提供借鉴.方法 结合近年国内外相关文献,分析8例术中意外发现腹膜假黏液瘤的误诊病例资料.结果 超声、CT、腹水细胞学、肿瘤标志物等检查结果有助于诊断,而病理检查可获得确诊以及腹膜假黏液瘤分型结果.通过完全肿瘤细胞减灭术或大部肿瘤切除术联合腹腔灌注化疗和全身化疗,8例患者中7例存活4～71个月不等,1例第3次手术后并发肺部感染进而呼吸衰竭死亡.结论 通过术前超声、CT、腹水细胞学、肿瘤标志物等检查可减少腹膜假黏液瘤误诊率.术中发现腹膜假黏液瘤后按照完全肿瘤细胞减灭术或大部肿瘤切除术进行手术或再次手术,并且进行腹腔灌注化疗以及常规全身化疗可以提高腹膜假黏液瘤患者生存率、延长生存时间.

Objective To investigate the diagnosis and treatment of pseudomyxoma peritonei （PMP） and provide a reference for diagnosis and treatment of PMP.Methods The clinical features,laboratory examinations,treatment and outcomes of 8 PMP misdiagnosed cases were analyzed with recent relevant reference.Results Ultrasonography,CT,peritoneal cytological examination,tumor markers results are helpful for diagnosis of PMP.PMP will be confirmed and classified by pathological examination after operation.Complete cytoreductive surgery （CRS）or major debulking surgery （MDS） of the tumor combined intraperitoneal chemotherapy and systemic chemotherapy,eight patients in seven cases survived 4-71 month range,one patient died of respiratory failure of pulmonary infection after the third operation.Conclusions Ultrasonography,CT,peritoneal cytological examination,tumor markers tests help avoid misdiagnosis of PMP before operations.Intraoperative findings follow after PMP,CRS or MDS should be executed in the operation or the next time.Intraperitoneal chemotherapy and conventional chemotherapy can improve survival in patients with PMP and prolong their survival time.