原发性纵隔肿瘤的诊断和治疗

Diagnosis and treatment of primary mediastinal tumors

目的 探讨原发性纵隔肿瘤的临床特点及手术治疗原则。方法 对 1988～ 2 0 0 1年本院收治的 4 8例原发性纵隔肿瘤的临床资料进行回顾性分析。结果 本组病例临床表现无症状 16例 ,有胸闷、气促、胸痛、发热、咳嗽等非特征性症状者 2 2例 ,有特征性临床症状者 10例。良性肿瘤手术切除率 10 0 % ,恶性肿瘤手术切除率 5 4 %。结论 良性原发性纵隔肿瘤 ,除少数确有手术禁忌者外 ,均应尽早手术治疗 ;对恶性原发性纵隔肿瘤 ,应针对不同的病理类型 ,采取不同的治疗方法 ;对瘤体较大的肿瘤或特殊类型肿瘤 ,应高度重视手术前后的处理 ;

Objective To investigate the clinical characters and the principle of operative treatment of primary mediastinal tumors.Method Clinical materials of 48 cases with primary mediastinal tumors who were treated in our hospital from 1988 to 2001 were retrospectively analyzed.Result 16 cases had no any symptoms. 22 cases had non characteristic symptoms like chest distress, pectoralgia, short breath, fever and cough, etc. 10 cases had characteristic symptoms. The operative removal rate of benign tumors was 100% and the rate of malignant tumors was 54%.Conclusion The patients with benign mediastinal tumors should be treated with operation as early as possible except that few patients had operative contraindication. The patients with malignant tumors should be treated with different methods according to different pathological types of tumors. Preoperative and postoperative management should be taken seriously for the patients with large tumors or special pathological types of tumors. Incisions should be made as close to lesions as possible.