儿童纵隔神经源性肿瘤单中心外科治疗经验  

Surgical treatment of pediatric mediastinal neurogenic tumors:A single center experience

作　　者：曹正浓 刘丹[1] 王雅楠 贾慧敏[1] Cao Zhengnong;Liu Dan;Wang Yanan;Jia Huimin(Department of Pediatric Surgery,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院小儿胸外科,沈阳110004

出　　处：《临床小儿外科杂志》2022年第3期231-235,共5页Journal of Clinical Pediatric Surgery

基　　金：国家自然科学基金(82070531);盛京医院345人才计划项目基金(40A);辽宁省兴辽英才计划项目资助(XLYC1908008)。

摘　　要：目的 分析儿童纵隔神经源性肿瘤行手术治疗患儿的临床特征、治疗方法及预后。方法 收集中国医科大学附属盛京医院小儿外科2012年1月至2021年12月间收治的30例纵隔神经源性肿瘤患儿临床资料,对其临床症状、影像学表现、治疗方法、病理类型及预后资料进行回顾性分析。结果 30例患儿平均年龄4.7岁(1~13岁),男20例,女10例。8例患儿未出现特异性症状(8/30,26.7%),7例为检查过程中意外发现,1例为肾上腺节细胞神经母细胞瘤术后随诊过程中发现;18例患儿因呼吸道症状就诊(18/30,60.0%),表现为咳嗽、咳痰、喘息等;2例胸背痛(2/30,6.7%);2例锁骨上淋巴结肿大(2/30,6.7%);12例伴发热(12/30,40.0%)。行胸腔镜手术16例(53.3%),胸腔镜辅助开胸手术9例(30.0%),开胸手术5例(16.7%)。术后病理检查结果:神经母细胞瘤4例(13.3%),神经节母细胞瘤8例(26.7%),节细胞神经瘤16例(53.3%),神经鞘瘤1例(3.3%),原始神经外胚层肿瘤2例(6.7%)。30例中良性16例(53.3%),恶性14例(46.7%)。结论 小儿纵隔肿瘤症状不典型,难以早期发现,胸部CT及MRI是诊断的主要手段,经手术治疗后预后相对较好。Objective To analyze the clinical features,treatment and prognosis of children with mediastinal neurogenic tumors.Methods The clinical symptoms,imaging manifestations,treatment,pathological types and prognosis of 30 children with mediastinal neurogenic tumors from January 2012 to December 2021 were retrospectively analyzed.Results The average age of children was 4.7 years(1-13 years),There were 20 males and 10 females.There were no specific symptoms in 8 cases(8/30,26.7%),7 cases were accidentally found during the examination,and 1 case was found during the follow-up of adrenal ganglioneuroblastoma;18 children were hospitalized due to respiratory symptoms(18/30,60.0%),manifested as cough,expectoration,wheezing and so on;2 cases of chest and back pain(2/30,6.7%);2 cases of supraclavicular lymph node enlargement(2/30,6.7%);12 cases were accompanied by fever(12/30,40.0%).16 cases(53.3%) underwent thoracoscopic surgery,9 cases(30.0%) thoracoscopic assisted thoracotomy,and 5 cases(16.7%) thoracotomy.The postoperative pathology revealed that there were 4 cases(13.3%) neuroblastoma,8 cases(26.7%) ganglioblastoma,16 cases(53.3%) ganglioneuroma,1 case(3.3%) schwannoma,and 2 cases(6.7%) Primitive neuroectodermal tumors.Among them,16 cases were benign(53.3%) while the rest 14 cases were malignant(46.7%).Conclusion The symptoms of mediastinal tumors in children are atypical which makes them difficult to be found early.Chest CT and MRI are the main means for diagnosis,and the prognosis is relatively ideal after surgical treatment.

关 键 词：膈/外科学 膈/病理生理学 肿瘤/外科学 肿瘤/诊断 治疗结果 儿童 

分 类 号：R734.5[医药卫生—肿瘤]