电视纵隔镜检查术在纵隔疾病诊断中的应用

目的探讨电视纵隔镜检查术在纵隔肿物和纵隔淋巴结肿大诊断中的应用价值。方法回顾性分析126例因纵隔占位或肺部占位合并纵隔淋巴结肿大拟诊断纵隔疾病行电视纵隔镜手术患者的资料，115例行颈部电视纵隔镜手术，11例行胸骨旁电视纵隔镜手术，在术中获取气管周围、胸骨后、隆突下以及双侧肺门等部位的肿物组织送病理检查。结果122例患者获得明确病理诊断，确诊率为96.83％；恶性病变54例（42.86％），良性病变68例（53.97％）；2例术前胸部 CT 考虑纵隔占位，术后病理结果不明，行食管镜及气管镜均未见明显异常；2例术前胸部 CT 考虑淋巴结肿大，术中病理未获明确诊断。良、恶性病例的性别、年龄进行比较，差异有统计学意义（P ＜0.05）。结论电视纵隔镜手术视野好，清晰度高，操作灵活，安全可靠，对于临床上难以确诊的纵隔疑难疾病是一种有效的诊断方法。

Applocation of video-mediastinoscipy in diagnosis of mediastinal disease

Objective To study the application of video-mediastinoscopy in the diagnosis and treatment of mediastinal tumors and medias-tinal lymphadenopathy. Methods The study was retrospective,and a total of 126 mediastinoscopies were performed for patients with undif-ferentiated mediastinal mass consisting of 115 cases of cervical video-mediastinoscopy and 11 cases of parasternal video-mediastinoscopyn,in order to obtain suspicious tissues at peritracheal,retrosternal,subcarinal,or bilateral hilar areas for pathological study. Results 122 of 126 patients with undetermined mediastinal mass had definitive pathologic diagnosis,and the diagnosis accuracy was 96. 83% . Of the 122 pa-tients,54 were diagnosed as malignancies,accounting for 42. 86% ;68 of the 122 were diagnosed as benign,accounting for 53. 97% of them. 4 cases of lymphoid tissue was without the express pathology. The comparison in gender and age in group of benign and malignant cases had statistically significant difference(P < 0. 05). Conclusion Video-mediastinoscopy is a valuable procedure which helps clarify the diag-nosis of mediastinal mass. Given its safety and efficacy,our experience with video-mediastinoscopy suggests that it should currently be used routinely in the diagnosis of undifferentiated mediastinal mass.