摘要
目的探讨纵隔镜手术在纵隔肿物诊断中的应用价值。方法1999年11月～2005年1月该科共为81例纵隔肿物患者进行了纵隔镜手术,对胸部CT等检查发现的纵隔病变进行活检,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。结果该组病人除1例外全部获得明确病理诊断,确诊率98.8%(80/81)。其中恶性病变37例(46.3%),良性病变43例(53.7%)。术前术后诊断符合率50.0%(40/80),术前误诊率50.0(%40/80)。在术前误诊的病例中以良性病变多见,该组43例良性病变中,有60.5(%26/43)的患者术前误诊为恶性肿瘤。该组纵隔镜手术后发生声音嘶哑1例,并发症发生率为1.2(%1/81)。无围手术期死亡。结论纵隔镜手术安全、可靠,对于临床上难以确诊的纵隔肿物是一种有效的诊断方法。
[Objective] To determine the value of mediastinoscopy in the evaluation of undifferentiated mediastinal mass. [Methods] The study was retrospective, a total of 81 mediastinoscopies were performed for patients with undifferentiated mediastinal mass between November 1999 and January 2005, in order to obtain suspicious tissues at peritracheal, retrosternal, subcarinal, or bilateral hilar areas for pathological study. [Results] 80 of 81 patients with undetermined mediastinal mass had definitive pathologic diagnosis, the diagnosis accuracy was 98.8%（80/ 81）. Of the 80 patients, 37 were diagnosed as malignancies, accounting for 46.3%. 43 of the 80 were diagnosed as benign, accounting for 53.7% of them. The diagnostic consistency of preoperation and pestoperation was 50.0% （40/ 80）, the misdiagnosis of preoperation was 50.0% （40/80）. In this series, the benigns were easier resulted in misdiagnosis. In 26 of 43 patients with benign disease, the initial diagnosis was malignancies, representing 60.5%. In the entire group of 81 patients, there were 1 complications （1.2%）, no perioperative death. [Conclusion] Mediastinoscopy is a valuable procedure which helps clarify diagnosis of mediastinal mass. Given its safety and efficacy, our experience with mediastinoscopy suggests that it should currently be used routinely in diagnosis of undifferentiated mediastinal mass.
出处
《中国内镜杂志》
CSCD
北大核心
2006年第9期925-927,共3页
China Journal of Endoscopy
关键词
纵隔镜检查
纵隔疾病
诊断
mediastinoscopy
mediastinal disease
diagnosis
