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目的 探讨电视纵隔镜手术在诊治胸部疾病及行肺癌分期的临床应用价值。 方法 回顾性分析北京协和医院2006年12月至2012年12月间行电视纵隔镜手术的74例患者, 其中男性41例, 女性33例, 平均年龄(49.1±14.6)岁(15~77岁)。均在全身麻醉下完成手术, 其中经颈部入路71例, 经胸骨旁入路3例。 结果 1例为脓肿引流, 另73例成功取得或切除目标组织, 最终病理结果包括肺癌纵隔淋巴结转移20例、结节病21例、结核12例、淋巴瘤5例、淋巴结反应性增生9例、恶性胸腺肿瘤2例, 其他诊断4例。手术平均时间58 min, 术中出血2例, 均成功压迫止血, 无死亡病例。 结论 纵隔镜技术安全有效, 对明确纵隔肿物性质以及肺癌分期具有重要价值, 是某些疑难疾病获得病理诊断的最佳途径。 -
表 1 电视纵隔镜手术患者术后病理结果
病理诊断 例数 构成比(%) 肺癌淋巴结转移 20 27.4 结节病 21 28.8 结核 12 16.4 淋巴瘤 5 6.8 淋巴结反应性增生 9 12.3 恶性胸腺瘤 2 2.7 纵隔囊肿 1 1.4 真菌感染 1 1.4 IgG4相关性淋巴结病I型 1 1.4 巨大淋巴结增生(Castleman病) 1 1.4 合计 73 100 
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