血管重建在原发性纵隔肿瘤中的临床应用

目的总结血管重建在原发性纵隔肿瘤中的应用经验和疗效。方法经外科手术治疗并血管重建的原发性纵隔肿瘤76例,22例（28.9%）单纯侵及上腔静脉;16例（21.1%）侵及单纯左或右无名静脉;34例（44.7%）侵及上腔静脉和左或右无名静脉;有4例（5.3%）单纯侵及主动脉外膜。行完整切除70例,部分切除6例;行血管置换46例,血管成形30例。结果全组病人无一例围术期死亡。上腔静脉阻断时间为（10-30）min,平均（18.0±5.3）min。左或右无名静脉单侧阻断时间为（11-25）min,平均（16.5±4.2）min。全组病人均获随访,时间为12-26个月,术后生活质量满意。结论纵隔肿瘤侵及上腔静脉及其属支大血管的病人,如全身无系统功能严重受损应积极手术治疗,可选用血管置换或血管成形术。

Clinical Application of Revascularization of the Primary Mediastinal Tumor

Objective To review the experiences of the revascularization in the surgery of mediastinal tumor. Methods 76 patients with mediastinal tumor were resected with vascular reconstruction including 46 patients of vascular replacement and 30 patients of vascular angioplasty. It invaded the superior vena cava in 22 patients, left or right innominate vein in 16 patients, the superior vena cava accompanied with left （ or right） innominate vein in 34 patients and only aortic adventitia in 4 patients. 70 patients were subjected to radical excision and 6 patients to palliative excision. Results There was no case of perioperative death. The blood block time of the superior vena cava was （ 18.0 ± 5.3 ） minutes. And the block time of the innominate vein was （ 16.5 ± 4.2 ） minutes. All the cases were satisfied with the quality of life during the follow - up for 12 to 26 months. Conclusion Operation is the first choice for mediastinal tumor patients whose superior vena cava and its branches are invaded without serious involvement of body system.