婴儿原发性纵隔肿瘤58例临床分析

Clinical analyses of mediastinal mass in 58 infants

目的通过分析婴儿原发性纵隔肿瘤的发病特点、临床表现、疗效与并发症,探讨其诊治经验。方法回顾性分析2010年1月至2叭4年12月间本院经手术治疗的58例原发性纵隔肿瘤患儿临床资料,总结其临床表现、原发部位、手术及术后并发症。结果 58例中,男33例,女25例,最小年龄15天,最大年龄12个月(平均4.5个月)。原发肿瘤中,神经源性肿瘤占51.7%,生殖细胞瘤占24.1%,间叶组织肿瘤占20.7%。42例出现临床症状,其中气促26例,占46.5%,发热5例,占8.6%,咳嗽5例,占8.6%,呼吸窘迫3例,占5.2%。良性肿瘤24例(占41.4%),恶性肿瘤34例(占58.6%)。均予手术治疗,其中根治性切除手术53例,大部分切除术5例,仅1例予术后化疗。58例已随诊2个月至5年,无手术相关死亡,无一例复发,术后出现霍纳氏综合征2例,膈神经损伤1例。结论婴儿纵隔肿物的早期诊断较困难,需依赖临床症状和胸部CT检查。手术是治疗婴儿纵隔肿瘤安全有效的治疗方案。

Objetive To determine the clinical manifestations,the surgical approach and management outcomes of paediatric patients with primary tumours of the mediastinum who underwent surgery. Methods A retrospective single-centre study was undertaken into patients with primary tumour of the mediastinum who un-derwent surgery between January 2010 and December 2014.We analysed demographic data,clinical presenta-tion,surgery procedure,lesion location and histological diagnosis. Results 58 patients underwent surgery,to-tal excision was performed in 52 patients,subtotal resection in 6 patients.33male （56.9%）and 25 female （43.1%）.Mean age was 4.5 months （15 days ~12 months）.The primary tumours included neurogenic tumours （51.7%）,germ cell tumours （24.1%）,thymic neoplasms （3.4%）,and a miscellaneous group （20.7%）.Malignant neoplasms were present in 34 patients （58.6%）.Symptoms were present in 74.3% of the patients and included polypnea （46.5%）,fever （8.6%）,cough （8.6%）,and respiratory distress syn-drome （5.2%）.There was no postoperative death.Follow-up was available in all 58 patients and ranged from 2 months to 5 years.Complementary treatment with chemo therapy was provided in 1 patient.no patient died of their disease during the follow-up period. Conclusions The early diagnosis of mediastinal mass is difficult, and depends on clinical manifestations and computerised tomography （CT）scan.Surgical excision is safe and effective treatment for mediastinal mass.