纵隔肿瘤的外科治疗(附112例手术分析)

Surgical Treatment of Mediastinal tumors

本文总结我院近21年经手术和病理检查证实的112例纵隔肿瘤的诊断与治疗.病理类型以神经源性肿瘤、畸胎类肿瘤及胸腺瘤为主(占77.7%).本病的诊断.X 线检查占有非常重要的地位.但作者提出肿块与纵隔交界切速角度大小不足以肯定或否定纵隔肿瘤的诊断.此外,畸胎类肿瘤较易并发感染或与周围组织粘连.甚至侵蚀外穿继发周围脏器感染,易致误诊.治疗原则是尽量早期完全摘除肿瘤.但对部份病例为避免损伤周围脏器及出血,可选择性地进行包膜下瘤体摘除.本文还讨论了术后发生截瘫的原因及预防.

This paper reports the diagnosis and treatment experience Of mediastinal tumors,112 cases,of our hospital,which proved by surgery and pathology,in recent 21 years.The ma- jority of this group are neurogenic tumors,terotodermoid tumors and thymomas(77.7%). Authors recommended that roentgenographic studying remain the most helpful diagnostic tools.But authors also suggested that more or less of the angle of boundary between neoplasm and mediastinum is not enough to make positive or negative diagnosis of mediastinal tumors.And terotodermoid tumors are easily accompaning with complicated infection or adhesion with adjacent structures,and sometimes can rupture into adjacent argans and proeluce a secondany infection.So,misdiagnosis of terotodermoid tumors is rather commonly.About treatment,it is recommended that complete removal of tumors as early as possible in general views.But some patients had to be selected to resect tumors be- neath the layer in order to avoid damaging adjacent important structures and bleeding dur- ing resection.This paper also discussed the cause and prevention of paraplegia which oc- cured after surgery.