外科治疗原发性气管肿瘤13例临床分析

Clinical analysis of 13 cases of primary tracheal tumor resction

目的总结外科手术治疗原发性气管肿瘤的临床经验。方法回顾分析我院1996～2006年13例手术治疗气管肿瘤的临床资料，采用颈领式切口1例，后外侧切口12例；3例患者在体外循环（Cardiopulmonarybypass，CPB）辅助下手术。结果切除长度1～5cm，平均切除气管长度为3．7cm；体外循环时间38～135min，平均76min；术后呼吸困难均有明显好转，围手术期无死亡。讨论气管节段切除手术是治疗气管恶性肿瘤的最有效方法。安全平稳的麻醉至关重要，对于严重梗阻的原发性气管肿瘤患者，应用体外循环（CPB）技术可降低麻醉手术风险，提供清晰术野和手术空间等有利条件，是解决气管切除及气道重建的有效方式。

Objective To analyzed the data of primary tracheal tumor resected. Methods The data of 13 cases of patients with primary tracheal tumors who underwent surgery under cardiopulmonary bypass from 1996 to 2006 were reviewed. Cardlopulmonary bypass was established through right femoral vessels in 2 patients, through fight atrium and ascending aorta in 1 patient. Sleeve tracheal resections were performed in 2patients, and sleeve tracheal resection and local enucleation were performed in 1 patient. Results All patients dyspnea were relieved remarkably, and CPB times were from 38min to 135min. There was no perioperative mortality. Conclusion Resection of primary tracheal tumors with severe tracheal obstruction under cardiopulmonary bypass is praticable. CPN can decrease the risk of tracheal tumors operation.