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目的总结胸内巨大肿瘤的外科治疗经验。方法分析15例胸内巨大肿瘤患者外科治疗的临床资料,男9例,女6例;右胸8例,左胸7例。肿瘤重2000～3800g。单纯肿瘤切除10例,合并左肺上叶切除2例并部分心包切除2例,上腔静脉成形术1例,4例加胸膜液氮冷冻治疗。结果无院内死亡。术后发生复张性肺水肿1例,胸腔内出血2例,均经积极救治后痊愈。结论积极的术前准备是关键,麻醉后气管、大血管受压可引起窒息、休克危险,应引起重视。手术切口要充分显露,术中可分块切除或控制瘤蒂后整个切除,注意术中大出血,防止发生复张性肺水肿。
Objective To summarize the surgical treatment of giant intrathoracic tumors. Methods Clinical data of 15 cases of giant intrathoracic tumor were analyzed. There were 9 males and 6 females, 8 cases of right chest and 7 cases of left chest. Tumor weight 2000 ~ 3800g. Simple tumor resection in 10 cases, combined with left upper lobe resection in 2 cases and partial pericardial resection in 2 cases, 1 case of superior vena cava angioplasty, 4 cases of pleural fluid nitrogen cryotherapy. No hospital deaths. Postoperative recurrent pulmonary edema in 1 case, 2 cases of intrathoracic hemorrhage, were cured after active treatment. Conclusion Positive preoperative preparation is the key. After anesthesia trachea and large blood vessel pressure can cause suffocation, shock danger, should pay attention. Surgical incision should be fully revealed during surgery can be divided into blocks or control of tumor pedicle after removal of the whole, pay attention to intraoperative bleeding, to prevent the occurrence of recurrent pulmonary edema.