纵隔肿瘤的诊断及外科治疗(附174例报告)

Surgical Treatment 174 Cases with Primary Tumor of the Mediastinum

目曲探讨纵隔肿瘤的临床特点和诊疗方法。方法分析1994年1月～2005年9月期间我科收治的174例纵隔肿瘤外科诊治的临床资料。结果174例中胸腺肿瘤89例，神经原性类肿瘤43例，畸胎瘤21例，纵隔囊肿9例，胸骨后甲状腺6例，淋巴瘤5例，血管瘤1例。其中恶性肿瘤共23例。手术切除166例（95．4％），姑息性切除2例，剖胸探查6例。随访3个月-3年。良性肿瘤无复发，恶性肿瘤出现远处转移7例，3年死亡6例，3年存活率73．9％。结论胸部X线和CT检查是诊断本病的主要手段，充分的围术期处理，认真选择切口，手术中防止重要组织器官损伤是保证手术安全的关键。

Objective To evaluate the clinical characteristics, diagnosis and treament in patients with primary tumor of the mediastinum. Methods 174 patients with primary tumor of the mediastium from Jan. 1994 to Sep. 2005 were retrospectively analysed. All patients received surgical treatment and pathologic examination. Results Among 174 patients, there were 89 thymomas（51.1% ）, 43 neumgenic tumors （24.7%）, 21 teratomas （12.1% ）, 9 mediastinal cyst, 6 intrathroacic goiter, and 6 others . A radical excision of the tumor was performed in 166 patients, palliative excision was performed in 2 patients, 6 patients underwent biopsy. No relapse were found in the benign primary mediastinal tumors who had received radical excision and 7 malignant tumor patients metastasised durind the fellowup of 3 months to 3 years. 3 years survival rates in 23 malignant tumor patients was 73.4 % （17/23）. Conclusion The chest X - ray and CT examination are the common access to diagnose primary mediastinal tumor. It is crucial for surgeons to ensure the security of the operation through satisfactory preoperative treatments, choosing correct incisions, preventing and curing trauma to the major organs during operation.