摘要
目的：总结腹膜假黏液瘤（PMP）的临床、影像及病理学特征，提高对该病的诊断、治疗水平。方法：检索CHKD全文数据库，对285例PMP病例进行统计分析。结果：PMP患者均以腹痛、腹胀为主要临床表现，病理来源以阑尾为主，其次是卵巢。腹部B超检查具有以下特征：不均质腹腔积液并有分隔，腹腔积液流动性差，腹腔多发蜂窝状无回声区，肝脾受压或肝脾多发囊性改变，腹腔或盆腔囊实性肿物。CT表现为腹腔积液CT值12～21Hu，肝脾扇形受压或囊性占位，腹腔多发蜂窝状低密度灶或腹腔积液分隔，网膜增厚，肠管聚集，腹腔或盆腔肿块密度不均。结论：PMP临床表现无特异性，易误诊，影像学检查结合腹腔穿刺有助诊断，确诊需病理检查。手术及术后腹腔内化疗为主要治疗手段。阑尾及卵巢手术时加强周围脏器保护为有效措施。
Objective：To summarize the clinical, imageology and pathological characteristics,diagnosis and treatment of PMP. Methods：285 PMP patients were statistically analyzed, using CHKD full-data base. Results： Abdominal pain and distention were mainly clinical symptoms. The predominant patho-origin was from appendix, the second was from ovary. Typical exhibitions of Ultrasonic B were non-uniform and chambered ascites which could not flow well,multiple honeycombing echoless areas in abdomen,pe- ripheral scalloping or multiple cysts of liver and spleen, cystic and entity mass in abdominal cavity or pelvic cavity. Typical exhibitions of CT were CT value was between 12-21Hu,peripheral scalloping or multiple cysts in liver and spleen,low-attenuation and honeycombing masses or chambered aseites in abdominal cavity, thicken retina; gathering intestine, non-uniform masses. Conclusion： PMP clinical manifestation showed no specific misdiagnosis. Typical imageology analysis and venter prick could provide clinical di- agnosis,while final conclusion depended on pathology. Operation and early postoperative intraperitoneal chemotherapy were top options. Protection of peripheral organs may reduce PMP during appendectomy and oothecectomy.
出处
《临床误诊误治》
2009年第7期1-4,共4页
Clinical Misdiagnosis & Mistherapy
