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目的 :通过胸膜间皮瘤的病因及临床表现的研究 ,从而提高诊断和治疗水平。方法 :选择 2 2例胸膜间皮瘤病人均行手术治疗 ,其中胸膜部分剥脱及肿瘤切除 9例、肺叶切除 3例、肺楔形切除肿瘤 3例、肺叶切除加胸膜部分切除 2例、胸膜全肺切除2例、瘤体巨大突入腹腔行姑息性切除 1例。年龄 40岁以上 ,男性 ,临床上有胸痛、气短、咳嗽、咯血丝痰、发热 ,胸廓变形 ,呼吸音减弱或消失 ,胸部X线、CT、MRI检查可了解瘤体的大小与周围组织及器官的关系 ,胸穿活检、胸腔镜检对本病有较高的诊断价值。本组良性胸膜间皮瘤占 3 6% ,恶性占 64 %。结果 :全组病人均无石棉接触史 ,确诊率为 3 6% ,术后随访率 81 8% (18/ 2 2 ) ,术后 1～ 2年的生存率分别 5 0 %和 2 5 %。结论 :胸膜间皮瘤的病因除了石棉接触史 ,可能与肺纤维化、胸部外伤或继发其他原因的胸膜疾患有关。良性胸膜间皮瘤手术治疗预后好 ,局限型恶性胸间皮瘤必须进行切除彻底、术后行放疗和化疗 ,弥漫性恶性胸膜间皮瘤预后不佳。
Objective: Through the pleural mesothelioma etiology and clinical manifestations of research, thereby enhancing the diagnosis and treatment. Methods: Twenty-two cases of pleural mesothelioma were treated by surgery, including partial pleural exfoliation and tumor resection in 9 cases, lobectomy in 3 cases, pulmonary wedge resection in 3 cases, lobectomy plus pleural partial resection in 2 cases, pleural whole lung Excision of 2 cases, huge tumor into the abdominal cavity palliative resection in 1 case. Men over the age of 40, men, clinically chest pain, shortness of breath, cough, hemoptysis sputum, fever, thoracic deformation, decreased or disappeared respiratory sounds, chest X-ray, CT, MRI examination can understand the size of the tumor with the surrounding tissues and organs The relationship between chest wear biopsy, thoracoscopy has a higher diagnostic value of the disease. Benign pleural mesothelioma accounted for 36%, malignant 64%. Results: No history of asbestos exposure was found in all patients. The diagnosis rate was 36% and the postoperative follow-up rate was 81.8% (18/2). The survival rates after 1 ~ 2 years were 50% and 25% respectively. CONCLUSIONS: In addition to the history of asbestos exposure, the etiology of pleural mesothelioma may be associated with pleural disorders such as pulmonary fibrosis, chest trauma, or other causes. Surgical treatment of benign pleural mesothelioma good prognosis, localized malignant thoracromatosis must be completely resected, postoperative radiotherapy and chemotherapy, diffuse malignant pleural mesothelioma prognosis is poor.