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腹腔热灌注化疗技术在腹膜假性黏液瘤治疗中的应用

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Author:: No author available

Journal Title:: CHINESE JOURNAL OF SURGERY

Issue:: 9

DOI:: 10.3760/j.issn.0529-5815.2006.09.018

Key Word:: No keyword available

Abstract： @@ 腹膜假性黏液瘤(pseudomyxoma pefitonei,PMP)是一种少见的以黏液外分泌细胞在腹膜种植并产生大量胶冻样黏液为特征的疾病[1].在临床外科上,将其分为原发性和继发性两种,继发性较原发性多见.继发性主要源于阑尾黏液囊肿、卵巢黏液性囊腺瘤或囊腺癌,为一种低度恶性病变.产生黏液的腺癌或囊肿原发瘤破裂后瘤细胞不经淋巴管或血管扩散,而种植于腹膜或腹腔脏器表面形成弥漫性转移灶,一般不发生脏器实质性浸润.病灶破裂聚集于腹腔中成为胶样黏液,导致腹腔广泛种植并不断产生黏液性物质,纤维组织增生产生广泛粘连[2].目前,临床上无特异性治疗方法,主要是通过手术去除病因,即设法根除卵巢、阑尾等病变,并尽可能清除腹腔内黏液物质.但该病在术后极容易复发,如何降低患者术后复发率,减少再次手术的可能性,提高患者的生存质量和生存率已成为困扰国内外学者的一大难题.1980年,国外学者Spratt等[3]根据肿瘤组织与正常组织的细胞对温度不同的耐受性和热化疗的协同效应,同时结合腹腔解剖学的特点,设计了一种新的化学治疗(化疗)技术--腹腔热灌注化疗技术(hyperthermic intraperitoneal chemotherapy,HIPEC),并应用该技术在治疗腹腔肿瘤中取得了突破.而Sugarbaker[4]将该项技术成功地运用于PMP的治疗中,并取得了理想的效果.本文就HIPEC在治疗PMP中的应用作一综述.

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