Luo W, Tang J, Qi Q
Department of Thoracocardiac Surgery, People's Hospital of Hunan Province, Changsha.
Zhonghua Zhong Liu Za Zhi. 1996 Jan;18(1):55-7.
In the past 22 years 90 cases of pathologically confirmed primary mediastinal tumors (PMT) were surgically treated. Of these 90 cases, there were 38 thymomas (42.3%), 19 teratoblastomas (21.2%), 9 neurofibromas (10.0%) and 24 others (26.5%). Radical excision was performed in 70 (77.8%), palliative excision in 6 (6.7%), exploratory thoracotomy in 12 (13.3%). Postoperative death occurred in 2 (2.2%). No relapse was reported in patients who had received radical excision during the follow-up period of 3 months to 13 years. Besides careful history taking and physical examination, X-ray examinations of the chest, particularly CT scan were valuable in the diagnosis and differential diagnosis of PMT. Difficulties in diagnosis were due to unusual pathological changes and clinical manifestations. Due precautionary measures should be taken to avoid injury to the heart, major blood vessels and the spinal cord. Cord injury was the consequence of direct operative trauma, compression due to intraspinal hemorrhage, and/or operative interruption of blood supply.
在过去22年中,对90例经病理确诊的原发性纵隔肿瘤(PMT)患者实施了手术治疗。在这90例患者中,有38例胸腺瘤(42.3%),19例畸胎瘤(21.2%),9例神经纤维瘤(10.0%),其他24例(26.5%)。行根治性切除术70例(77.8%),姑息性切除术6例(6.7%), exploratory thoracotomy 12例(13.3%)。术后死亡2例(2.2%)。在3个月至13年的随访期内,接受根治性切除术的患者未报告复发。除了仔细询问病史和体格检查外,胸部X线检查,尤其是CT扫描对PMT的诊断和鉴别诊断有重要价值。诊断困难是由于不寻常的病理变化和临床表现。应采取适当的预防措施,避免损伤心脏、大血管和脊髓。脊髓损伤是直接手术创伤、脊髓内出血压迫和/或手术中断血液供应的结果。 (注:原文中“exploratory thoracotomy”未准确翻译,可译为“剖胸探查术” )