【摘要】：目的：通過(guò)探討惡性腹膜間皮瘤的發(fā)病機(jī)制、臨床特征、相關(guān)檢查、診療、預(yù)后等,以提高對(duì)本病的診治水平。方法：通過(guò)分析1例惡性腹膜間皮瘤患者的臨床資料來(lái)復(fù)習(xí)相關(guān)文獻(xiàn),并進(jìn)行總結(jié)。資料：一男性患者,入院前腹脹,行腹部B超提示大量腹腔積液。干預(yù)措施：行各項(xiàng)常規(guī)、腹穿、全腹增強(qiáng)CT、PET-CT、電子胃鏡、結(jié)腸鏡及病理學(xué)活檢明確診斷后,給予全身化療、維護(hù)臟器功能、增強(qiáng)免疫力、能量支持等對(duì)癥治療,后因病情進(jìn)展迅速行相關(guān)的搶救措施。結(jié)果：在排外常見引起腹水病因疾病的基礎(chǔ)上,最后行PET-CT示：腹膜、網(wǎng)膜、腸系膜彌漫性FDP代謝異常增高,建議行病理學(xué)檢查。腹腔鏡下可見大小、形態(tài)均不一的灰白色結(jié)節(jié)散在分布于大網(wǎng)膜、壁層腹膜、胃及小腸漿膜面。術(shù)后病檢示惡性腹膜間皮瘤(上皮型),明確診斷。結(jié)論：惡性腹膜間皮瘤屬少見疾病,其臨床表現(xiàn)、腹水及相關(guān)影像學(xué)檢查等均無(wú)特異性,故針對(duì)腹水原因待查者,在考慮常見病同時(shí),不要忽視一些罕見病的可能。因預(yù)后較差,故需加強(qiáng)對(duì)其認(rèn)識(shí),做到早預(yù)防、早診療。
[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.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.5

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