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目的：探讨原发性纵隔肿瘤的临床特点、诊治方法。方法：回顾分析我院1969年1月～1997年12月收治并经病理证实的407例原发性纵隔肿瘤。结果：胸腺瘤184例（45．2％），畸胎瘤99例（24．3％），神经源性肿瘤70例（1．2％），其它54例（1．3％）；除无手术指征的17例使用放、化疗外，手术探查390例，其中肿瘤完整切除352例，姑息性切除18例，手术切除率94．9％（370／390），探查20例；术后随诊1个月至28年，良性纵隔肿瘤未见复发。恶性胸腺瘤54例中，一年生存率88．8％（48／54），3年64．8％（35／54），5年57．4％（31／54），10年46．3％（25／54）。恶性畸胎瘤14例中，1年生存率50％（7／14），3年28．6％（4／14），5年14．3％（2／14）。结论：本病诊断主要依靠临床症状和X线、CT检查；治疗应以手术为主；对巨大的或手术较困难的纵隔肿瘤的手术治疗应做好充分准备；手术进路视肿瘤的大小和部位而定。
Objective: To investigate the clinical features, diagnosis and treatment of primary mediastinal tumors. Methods: Retrospective analysis of 407 cases of primary mediastinal tumors admitted in our hospital from January 1969 to December 1997 and confirmed by pathology. RESULTS: 184 cases (45.2%) of thymoma, 99 cases (24.3%) of teratoma, 70 cases (1.2%) of neurogenic tumors, and 54 cases (1.3%); Among the 17 surgical indications, radiotherapy and chemotherapy were used in 17 cases. 390 surgical explorations were performed, including 352 cases of complete tumor resection and 18 cases of palliative resection. The surgical resection rate was 94.9% (370/390), and exploration was performed in 20 cases; From 1 to 28 years of diagnosis, there was no recurrence of benign mediastinal tumors. In 54 cases of malignant thymoma, the one-year survival rate was 88.8% (48/54), three years 64.8% (35/54), five years 57.4% (31/54), 10 years 46.3 %(25/54). Among the 14 cases with malignant teratoma, the one-year survival rate was 50% (7/14), 28.6% (4/14) in 3 years, and 14.3% (2/14) in 5 years. Conclusion: The diagnosis of the disease mainly depends on clinical symptoms and X-ray and CT examinations. The treatment should be based on surgery. The surgical treatment of large or difficult-to-severe mediastinal tumors should be fully prepared; the size of the surgical approach depends on the size of the tumor. Location.