CAJ | 학술논문

目的探讨胸内巨大实质性肿瘤的诊断与外科治疗经验.方法回顾性分析经手术治疗的36例胸内巨大肿瘤患者的临床资料.其中肿瘤彻底切除34例,同期行上腔静脉成形术3例,左无名静脉结扎术2例.6例患者术后加用放射治疗.结果 36例患者中,围术期死亡2例,占5.6%.术后平均住院时间为14.2 d.症状明显改善者32例,术后出现复张性肺水肿6例.随访1～22年,良性肿瘤患者平均存活时间为10.0年,恶性肿瘤患者平均存活时间为2.1年.结论对胸内巨大实质性肿瘤患者尽可能采取手术治疗,即使不能彻底根治,术后加用放射治疗也能取得良好疗效.选择正确的麻醉方法与合适切口,结合具体情况采取不同的切除方式和止血方法是成功的关键.
목적 탐토흉내거대실질성종류적진단여외과치료경험.방법 회고성분석경수술치료적36례흉내거대종류환자적림상자료.기중종류철저절제34례,동기행상강정맥성형술3례,좌무명정맥결찰술2례.6례환자술후가용방사치료.결과 36례환자중,위술기사망2례,점5.6%.술후평균주원시간위14.2 d.증상명현개선자32례,술후출현복장성폐수종6례.수방1～22년,량성종류환자평균존활시간위10.0년,악성종류환자평균존활시간위2.1년.결론 대흉내거대실질성종류환자진가능채취수술치료,즉사불능철저근치,술후가용방사치료야능취득량호료효.선택정학적마취방법여합괄절구,결합구체정황채취불동적절제방식화지혈방법시성공적관건.
Objective To summarize the experience in diagnosis and surgical treatment of giant intrathoracic solid tumors. Methods The data of surgically treated 36 patients with giant intrathoracic solid tumors were analyzed, including 19 males and 17 females. Complete resection was achieved in 34 cases with superior vena cava angioplasty in 3 cases and ligation of the left anonymous vein in 2 cases. Six patients received postoperative radiotherapy. Results The symptoms in 32 cases were significantly improved. Two patients (5.6%) died of postoperative respiratory infection and failure. The mean postoperative hospital stay was 14.2 days. Pulmonary edema occurred in 6 cases due to rapid decompression of the lung. Pathological results showed that 25 cases had benign tumors and 11 had malignancy. During the follow-up of 1 to 22 years, all patients with benign tumors were still alive, but the patients with malignant tumors had a mean survival time of only 2. 1 years. Conclusion Surgical treatment for giant intrathoracic solid tumors is suggested whenever technically possible. Even though a tumor can not be completely resected, satisfied results could still be achieved if combined with postoperative radiotherapy. Proper anesthesia, satisfied exposure with a suitable incision, appropriate resection pattern and hemostatic method are the keys for successful surgical treatment.