手术治疗右上纵隔肿瘤伴上腔静脉阻塞综合征的临床分析

Clinical analysis of operating for the upper-righted mediastinal tumor with superior vena cava syndrome

目的探讨手术治疗右上纵隔肿瘤合并上腔静脉阻塞综合征的手术方法与疗效。方法选取17例右上纵隔肿瘤并上腔静脉阻塞综合征行手术治疗的患者进行回顾性分析,其中恶性胸腺瘤7例,畸胎瘤4例,恶性间皮瘤1例,纵隔型肺癌2例,淋巴瘤3例。17例患者均采用血管置换上腔静脉及左无名静脉,其中12例采用Gore-tex人工血管置换,2例采用人工自体心包制作成管状代血管,3例采用人工牛颈静脉血管置换。结果 17例患者中16例患者术后上腔静脉梗阻症状均明显改善。除1例术后因呼吸困难放弃治疗出院,随访1个月后呼吸衰竭死亡外,其余患者术后存活时间为5~45个月。结论人工血管置换手术治疗右上纵隔肿瘤并上腔静脉阻塞综合征疗效确切,症状改善明显,并能显著延长患者生存期,手术方法操作切实可行,非临床绝对禁忌,值得临床推广。

Objective To study the operation effect of the upper-righted mediastinal tumor with superior vena cava syndrome(SVCS).Methods To review17cases operated of upper-righted mediastinal tumor with SVCS,in which,12cases replaced vessel with Gore-tex artificial vessel,2cases with own pericardium made for tubiform instead the vessel,3cases with cow neck vein.Results16cases recovered but1case died by breathe failure after one month of operation.The survival time was5～45months after operation.Conclusion The operation using the artificial vessel replace the superior vena was a definitive method and had a longer life span.The operation method is definitely feasible and worth to be spead.