上皮型腹膜恶性间皮瘤1例并文献复习
发布时间：2018-11-10 08:01
【摘要】：目的：通过探讨恶性腹膜间皮瘤的发病机制、临床特征、相关检查、诊疗、预后等,以提高对本病的诊治水平。方法：通过分析1例恶性腹膜间皮瘤患者的临床资料来复习相关文献,并进行总结。资料：一男性患者,入院前腹胀,行腹部B超提示大量腹腔积液。干预措施：行各项常规、腹穿、全腹增强CT、PET-CT、电子胃镜、结肠镜及病理学活检明确诊断后,给予全身化疗、维护脏器功能、增强免疫力、能量支持等对症治疗,后因病情进展迅速行相关的抢救措施。结果：在排外常见引起腹水病因疾病的基础上,最后行PET-CT示：腹膜、网膜、肠系膜弥漫性FDP代谢异常增高,建议行病理学检查。腹腔镜下可见大小、形态均不一的灰白色结节散在分布于大网膜、壁层腹膜、胃及小肠浆膜面。术后病检示恶性腹膜间皮瘤(上皮型),明确诊断。结论：恶性腹膜间皮瘤属少见疾病,其临床表现、腹水及相关影像学检查等均无特异性,故针对腹水原因待查者,在考虑常见病同时,不要忽视一些罕见病的可能。因预后较差,故需加强对其认识,做到早预防、早诊疗。
[Abstract]:Objective: to improve the diagnosis and treatment of malignant peritoneal mesothelioma by exploring its pathogenesis, clinical features, correlative examination, diagnosis and treatment, prognosis and so on. Methods: the clinical data of a case of malignant peritoneal mesothelioma were reviewed and summarized. Materials: a male patient with abdominal distension before admission underwent abdominal B-ultrasound indicating a large amount of abdominal effusion. Intervention measures: routine, abdominal puncture, total abdominal enhanced CT,PET-CT, electronic gastroscopy, colonoscopy and pathological biopsy were given systemic chemotherapy, maintenance of organ function, enhancement of immunity, energy support and other symptomatic treatment. After the rapid progress of the disease to carry out the relevant rescue measures. Results: on the basis of common ascites etiological diseases caused by exclusion, PET-CT showed that the metabolism of diffuse FDP in peritoneum, omentum and mesentery was abnormal. Pathological examination was recommended. Under laparoscopy, gray and white nodules of different sizes and shapes were scattered in the greater omentum, parietal peritoneum, stomach and small intestine serosa. Postoperative diagnosis of malignant peritoneal mesothelioma (epithelial type) was confirmed. Conclusion: malignant peritoneal mesothelioma is a rare disease, and its clinical manifestations, ascites and related imaging examination are not specific. Because of poor prognosis, it is necessary to strengthen its understanding, early prevention, early diagnosis and treatment.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.5
本文编号：2321877
[Abstract]:Objective: to improve the diagnosis and treatment of malignant peritoneal mesothelioma by exploring its pathogenesis, clinical features, correlative examination, diagnosis and treatment, prognosis and so on. Methods: the clinical data of a case of malignant peritoneal mesothelioma were reviewed and summarized. Materials: a male patient with abdominal distension before admission underwent abdominal B-ultrasound indicating a large amount of abdominal effusion. Intervention measures: routine, abdominal puncture, total abdominal enhanced CT,PET-CT, electronic gastroscopy, colonoscopy and pathological biopsy were given systemic chemotherapy, maintenance of organ function, enhancement of immunity, energy support and other symptomatic treatment. After the rapid progress of the disease to carry out the relevant rescue measures. Results: on the basis of common ascites etiological diseases caused by exclusion, PET-CT showed that the metabolism of diffuse FDP in peritoneum, omentum and mesentery was abnormal. Pathological examination was recommended. Under laparoscopy, gray and white nodules of different sizes and shapes were scattered in the greater omentum, parietal peritoneum, stomach and small intestine serosa. Postoperative diagnosis of malignant peritoneal mesothelioma (epithelial type) was confirmed. Conclusion: malignant peritoneal mesothelioma is a rare disease, and its clinical manifestations, ascites and related imaging examination are not specific. Because of poor prognosis, it is necessary to strengthen its understanding, early prevention, early diagnosis and treatment.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.5
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