【作者】 于绍轶；

【导师】 于学军；

【作者基本信息】 山东大学 ， 肿瘤学， 2007， 硕士

【摘要】 目的探讨恶性胸膜间皮瘤的病因、临床表现、误诊情况、诊断和治疗的临床规律以及相关进展。方法回顾性总结山东大学齐鲁医院1996年至2006年收治且资料完整的恶性胸膜间皮瘤患者31例，对其性别、年龄、石棉接触史、临床表现、误诊情况、影像学检查、诊断方法、治疗过程等方面进行分析。结果(1)本组病例男15例，女16例(男：女=1：1)，发病年龄：28-82岁，中位发病年龄：54岁，所有患者均无石棉接触史。(2)临床表现主要为胸痛、胸闷、咳嗽、气急及胸腔积液，14例X线片可见胸水，26例CT发现胸膜不规则增厚或胸腔内结节影，18例经胸膜活检和胸水细胞学检查获取病理学依据。(3)大部分患者单纯行手术治疗、放疗或化疗，3例行综合治疗。结论对临床上进行性胸痛、咳嗽、气急患者，胸片及CT显示有胸水并胸膜增厚或胸膜结节者应警惕胸膜间皮瘤，胸膜活检和胸水细胞学检查是主要确诊方法。对于恶性胸膜间皮瘤，综合治疗的效果较单一治疗手段好。更多还原

【Abstract】 ObjectiveTo investigate the clinical rule and advance in the pathogeny、diagnoses and treatment of malignant pleural mesothelioma.MethodsA retrospective study was conducted in 31 cases of malignant pleural mesothelioma hospitalized from 1996 to 2006 ,whose clinical data was analysed including sex,age,clinical manifestations ,imaging examinations ,diagnoses and treatment.Results(1) Of all the 31 cases, 15 cases were male, 16 cases were female, Male: female= 1:1; the age of patients were from 28 to 82, and the expective of live were 54. All the cases had no evident history of exposure to asbestos. (2)The clinical manifestation were mainly chest pain , chest depressed , cough ,dyspnea and pleural effusion. 14 cases had pleural effusion under X-ray and pleural anomaly thickening or nodules were found in 26 cases on CT examination. Of all the diagnosed cases, 18 cases were diagnosed via biopsy of pleura and cytologic examination in pieural effusion.(3)Most cases were only treated with operation , radio- therapy and chemotherapy while 3 cases were treated with combined therapy.ConclusionThe patient with progressive chest pain ,cough and dyspnea,who also has pleural effusion ,pleural thickening or nodules on X-ray or CT examination should pay attention to the fact that maybe he has had pleural mesothelioma. Biopsy of pleura and cytologic examination in pieural effusion are the most important diagnoses measure.To malignant pleural mesothelioma,combined therapy is better than single means.更多还原