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目的 :探讨 2 3 8例原发性纵隔肿瘤的诊断及外科治疗经验。方法 :1977年 3月 1日～ 2 0 0 2年 11月 1日经手术治疗且病理证实的原发性纵隔肿瘤及囊肿 2 3 8例。其中胸腺肿瘤 10 4例 ( 4 3 7% ) ,并发重症肌无力 19例 ,发生危象 9例 ;畸胎类肿瘤 3 9例( 16 4% ) ;神经源性肿瘤 3 5例( 14 7% ) ;胸内甲状腺肿 2 6例( 10 9% ) ;纵隔囊肿 17例 ( 7 1% ) ;其他肿瘤 17例 ( 7 1% )。结果 :2 3 8例中彻底切除 2 3 1例 ( 97 0 0 % ) ,7例未能彻底切除者 ,术后给予放疗。术后重症肌无力危象死亡 1例 ( 0 4% ) ,2 3 7例痊愈。结论 :胸部X线及CT检查对纵隔肿瘤的诊断起主要作用 ,手术切除是本病有效的治疗方法。强调早期诊断 ,及时手术 ,对不同部位的肿瘤采取不同入路 ,注意术中特殊情况的处理。
Objective: To investigate the diagnosis and surgical treatment experience of 233 cases of primary mediastinal tumors. Methods: From March 1, 1977 to November 1, 2002, 238 primary mediastinal tumors and cysts were surgically treated and pathologically confirmed. There were 104 cases (43.7%) of thymic tumors, 19 cases of myasthenia gravis (MG), 9 cases of crisis, 39 cases of teratoid tumors (16.4%), 35 cases of neurogenic tumors (14.7% ); Intrathoracic goiter in 26 cases (109%); mediastinal cyst in 17 cases (71%); other tumors in 17 cases (71%). Results: Twenty-three cases (97.0%) were completely resected in 2388 cases and 7 cases were not completely resected. Radiotherapy was given after operation. Postoperative death from myasthenia gravis crisis were found in 1 case (0 4%) and in 2 37 cases were cured. Conclusion: Chest X-ray and CT examination play a major role in the diagnosis of mediastinal tumors. Surgical resection is an effective treatment for this disease. Emphasize the early diagnosis, timely surgery, take different approaches to the tumor of different parts, pay attention to the treatment of special circumstances.