气管前间隙病变的诊断及手术治疗  

The evaluation and surgical treatment of mass in the pretracheal space

作　　者：申虹[1] 魏伯俊[1] 彭振兴[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院耳鼻咽喉头颈外科首都医科大学耳鼻咽喉科学院耳鼻咽喉头颈外科学教育部重点实验室(首都医科大学),100038

出　　处：《中华耳鼻咽喉头颈外科杂志》2016年第6期451-453,共3页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的总结气管前间隙病变的病理类型，临床表现特点及治疗方法。方法回顾性总结1999年至2014年，首都医科大学附属北京世纪坛医院耳鼻咽喉头颈外科11例存在气管前间隙占位性病变患者的临床表现，临床特点及治疗经过。其中，男3例，女8例，年龄32—61岁，平均年龄43岁。除体格检查外尚行B超、CT、核素显像、内镜检查、抽液检查或抽血检查等。所有患者在全麻下行气管前占位性病变切除，术后常规持续负压引流。结果6例质地较硬包块具有较大的横向活动度，但随吞咽活动轻微。B超和cT均显示气管前间隙内病变边界清晰，与甲状腺有明显组织间隔。病理结果为结节性甲状腺肿6例，甲状旁腺瘤2例，甲状旁腺囊肿、胸腺瘤和淋巴管囊肿各1例。无术后活动性出血、淋巴漏、乳糜漏或喉返神经损伤等并发症。超声随访7～42个月未见复发，甲状旁腺瘤患者甲状旁腺激素及血钙和尿钙均在正常范围。结论迷走性甲状腺结节性肿大、异位性甲状旁腺瘤和胸腺瘤为气管前间隙的主要原发性病变，手术治疗安全有效。Objective To study the pathological and clinical features and the surgical results of the mass in the pretracheal space. Methods From 1999 to 2004, 8 females and 3 males with an average of 43 years （from 32 to 61 years） were included CT scan, nuclear imaging, ultrasound and ultrasound-guided aspiration, endoscopic and laboratory measure were used in the evaluation for the masses before operation. Complete removal of mass was carried out in all patients under general anesthesia, and continuous negative pressure draining was routinely used. Results Six masses with firm consistency could be moved easily transversely, but slightly moveable with swallowing. On contrast CT or ultrasound, all the masses had clear circumscription and showed rounded or lobular shape. No hemorrhage, chylous or lymph leakage, or recurrent laryngeal injury was encountered. Goiter was found in 6 cases, parathyroid adenoma in 2 cases, and thymoma, parathyroid cyst or lymphatic cyst was diagnosed in the rest three patients respectively. No recurrence was found with the following-up of 7 - 42 months. Conclusions Goiter, parathyroid adenoma and thymoma were common lesions presenting as mass in the pretracheal space and surgically curable without complications.

关 键 词：气管前间隙 甲状腺肿 甲状旁腺瘤 手术 

分 类 号：R653[医药卫生—外科学]