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h6nzshw856
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h6nzshw856
 
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Last Login: 8/24/20
Join Date: 8/24/20
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My Website: https://j6gsszb680.wixsite.com/fernandoe...
About Me: 腹膜轉移佔結直腸癌患者的25%。隨著醫療技術得發展，醫生對結直腸癌腹膜轉移的治療采取了積極的治療措施，如腹腔熱灌註化療以及腹膜切除術為主的綜合治療。
結直腸癌腹膜主要轉移途徑主要有兩個，第一： 腫瘤細胞直接浸透漿膜後脫落至腹腔引起；第二：醫源性因素導致。手術區域被切斷血管／淋巴管內癌栓隨血流和／或淋巴液流入到腹腔內、牽拉擠壓腫瘤組織、腫瘤細胞隨腸液經腸腔殘端流入腹腔等均可導致術中腫瘤細胞在腹腔內的種植。
結直腸癌腹膜轉移的診斷方式常見包括增強計算機斷層掃描(CT)、磁共振成像(Mm)、正電子發射顯像(PET)．CT、血液腫瘤標志物、腹水或腹腔灌註液細胞學檢查、腹腔鏡探查等。
1.血液腫瘤標志物：血液中CEA、CA125、CA199水平明顯增高時，往往提示腫瘤惡性程度高、分化差、易發生轉移。需要註意的是，也有一部分患者血清學指標不高，但出現了腹膜轉移。
2.免疫學檢查：細胞角蛋白20（CK20）在細胞發生化生、惡變、腫瘤轉移、體外培養等異常時，這種表達持續存在，作為結直腸癌腹膜轉移的評估有一定意義。
3.影像學檢查：常用的方法有CT、MRI、PET。
CT具有較高的分辨率，其診斷結直腸癌腹膜轉移的標準為：一，腹腔積液；二，網膜和腸系膜改變，包括網膜及系膜出現汙垢狀、結節狀或餅狀軟組織影；三，腸系膜糾集；四，腹膜增厚，包括肝周、膈下、腹腔前、側壁腹膜增厚；五，腹腔內局限性積液；六，小腸壁增厚和腸管移位。
動態影像多采取造影劑直接或間隔一定時間段再次觀察，在胃癌腹膜轉移中使用動態成像來評估腸系膜受累攣縮情況以及用造影劑通過各組腸管的時間來推測是否有腸梗阻跡象。在結直腸癌中，出現腹膜轉移，多伴有腸管腫瘤的播散，腸管蠕動能力下降。在判定腫瘤
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