西宁地区心脏粘液瘤外科治疗

目的：加强及完善西宁地区心脏粘液瘤外科治疗。方法：我院自1991年3月—2007年4月共收治32例心脏粘液瘤,其中30例左心房粘液瘤,2例右心房粘液瘤。均在全麻、体外循环下行粘液瘤摘除术,5例同时三尖瓣成形术。结果：无围术期死亡,无心功能衰竭,随诊3个月～16年。手术后无复发。结论：西宁地区地处高海拔地区,心脏粘液瘤发展迅速,病程时间短,一经确诊应立即手术,效果好、安全。超声心动图对心脏粘液瘤诊断有极其重要的作用。     

心脏粘液瘤4例报告

自1964年初至1986年10月,我院经手术证实的心脏粘液瘤23例,现将其中心房粘液瘤的复发、右室及左室粘液瘤等4例作一介绍。 一、左、右房粘液瘤并切除后复发 例1 男,28岁,因活动后心慌气短4年,加重4个月,于1979年3月6日第一次入院。查体:心界向左扩大,律齐,心尖闻及Ⅲ级舒张期杂音,心电图示:左右房扩大,不完全右束支传导阻滞。超声心动图示:双心房内有异常增强的光团。于4月20日行粘液     

原发性心脏肿瘤的诊断与外科治疗

目的：探讨心脏原发性肿瘤的诊断和外科治疗经验。方法：1985－01～2001－06手术治疗的49例心脏原发性肿瘤病例进行回顾性分析。结果：手术死亡1例，42例心脏粘液瘤无远期死亡和复发，恶性肿瘤均手术后6个月内死亡。结论：原发性心脏肿瘤的诊断以二维超声检查为佳，治疗均需尽早手术治疗。手术切除时应尽可能全层广泛切除以免术后复发，同时注意心脏功能和结构完整性。     

心脏粘液瘤的诊断与外科治疗

心脏粘液瘤的诊断与外科治疗李庆新★高秀峰★吕国祯★徐克劲★董逸飞★樊西林★关键词心脏粘液瘤诊断外科治疗超声心动图中国图书资料分类法分类号Ｒ７３２．１我科自１９８３年１月至１９９５年１２月共收治心脏粘液瘤８例，现简要报告如下。１临床资料本组男６例，女２...     

心脏粘液瘤

心脏肿瘤较少见，而心脏粘液瘤为其中最常见的原发性心脏肿瘤，本文收集了自1978年至1986年我院经手术证实的心脏粘液瘤42例，以X线表现和诊断方法作为重点，并复习文献进行讨论。     

心脏原发性肿瘤的超声鉴别诊断

目的：探讨心脏粘液瘤、脂肪瘤和横纹肌瘤的超声鉴别诊断。材料和方法：利用超声心动图检查３６ 例心脏肿瘤,其中粘液瘤３０ 例,脂肪瘤４ 例,横纹肌瘤２ 例。均经手术病理证实。通过左室长轴、短轴、四腔和五腔心等切面观察肿瘤的部位、形态、包膜、活动度、界线和回声特征。结果：粘液溜多发生在左房,有明确的瘤蒂,肿瘤活动度较大,有分叶。脂肪瘤与粘液瘤不同处是多发生在左室,活动度较小,有漂浮感,肿瘤回声较强,没有分叶。横纹肌瘤发生在室壁心肌内,肿瘤与正常心肌间有明确的界线。结论：超声心动图对心脏原发性肿瘤的鉴别诊断具有重要意义。     

右房粘液瘤38例国内文献综述

心脏粘液瘤较少见,本文复习国内有关文献66篇,共获心脏粘液瘤349例,其中左房粘液瘤295例(84.5%),右房粘液瘤38例(10.9%),双房粘液瘤4例(1.15%),左室粘液瘤2例(0.57%),右室粘液瘤7例(2%),左房左室多发粘液瘤2例(0.57％),四腔室多发性粘液瘤1例(0.29%)。鉴于右房粘液瘤罕见,临床极易误诊,现将上述38     

超声心动图诊断原发性心脏肿瘤

目的：探讨原发性心脏肿瘤超声心动图(ECG)特征。方法：利用ECG检查42例心脏肿瘤。其中粘液瘤38例，恶性肉瘤2例，均经手术病理证实。横纹肌瘤2例，经随访证实。结果：ECG对38例粘液瘤，2例横纹肌瘤全部做出正确诊断。2例恶性肿瘤提示相应部位占位病变。粘液瘤多发生在左房，有明确的瘤蒂，肿瘤回声稀疏，活动度大。恶性肿瘤回声较强、无蒂，活动度小。横纹肌瘤多发生在室壁心肌内，呈结节状，与正常心肌间有明确的界限。结论：ECG对原发心脏肿瘤的诊断具有重要意义，可初步区分良、恶性肿瘤。     

心脏粘液瘤的诊断与治疗:附10例临床报告

心脏粘液瘤是一种少见疾病,但对病人的危害极大.可引起猝死、栓塞等并发症.心脏粘液瘤是一种可治愈的疾病,多数病人可恢复劳动力.但部分心脏粘液瘤患者常常以心外表现为主要临床症状或唯一症状,以致部分病人得不到早期诊断和及时手术治疗,出现栓塞而残疾或猝死.因此早期诊断和及时手术治疗有重要意义.     

肌内粘液瘤(X线、CT所见与病理的相关)

肌内粘液瘤(Intramuscular Myxoma,简称IMM)在病理及外科文献上已有不少报导,但在X线文献上尚未有对之分析者。Stout在1948给粘液瘤作了如下定义:粘液瘤是发生在疏松粘液样基质的,由星状细胞组成的一种真性肿瘤,向各个方向伸出非常纤细的网状纤维,酷似原始间胚叶。他又指出,此瘤决不可有其它分化良好的成分,如成脂细胞,成软骨细胞或成横纹肌细胞的存在。粘液瘤好发顺序如下:心脏,皮下及腱膜组织,骨,生殖泌尿系统及肌肉。心脏粘     

71例心脏黏液瘤的临床诊断和治疗

目的研究心脏黏液瘤的临床特点,总结外科手术经验。方法回顾性分析1989年12月～2005年5月在解放军总医院行手术治疗的71例原发性和复发性心脏黏液瘤患者,其中男性29例,女性42例,年龄40.12±12岁(12～63岁),所有患者术前均经超声心动图检查明确诊断,合并心脏病变术中一并纠治,切除的肿瘤组织常规行病理学检查。结果71例患者中左房黏液瘤66例(92.9%),右房黏液瘤3例(4.2%),右室黏液瘤1例(1.45%),左室黏液瘤1例(1.45%);3例患者(4.2%)黏液瘤为术后复发;6例患者(8.6%)有栓塞史。绝大多数左房黏液瘤的临床表现与二尖瓣狭窄类似,右房黏液瘤及右室黏液瘤患者出现右心功能不全症状,左室黏液瘤患者出现左室流出道狭窄症状并在主动脉瓣听诊区闻及收缩期喷射样杂音。合并冠状动脉病变2例,风湿性二尖瓣狭窄2例,二尖瓣中重度关闭不全3例,三尖瓣重度反流4例。手术均在体外循环下进行,手术死亡1例,术后反复复发1例,其余患者均恢复良好。所有患者病理学检查均证实黏液瘤病变。结论超声心动图可准确诊断心脏黏液瘤,一旦确诊,均应立即手术;心脏黏液瘤术后可复发,需长期随访。     

心脏黏液瘤31例临床特征与手术治疗分析

目的探讨心脏黏液瘤的临床特征和手术治疗方法。方法31例心脏黏液瘤患者,在低温体外循环下进行黏液瘤切除术。结果术后死亡1例,其余患者术后恢复好,临床症状消失,心功能恢复至I级。随访6个月～10年,未见肿瘤复发和远处种植转移。结论超声心动图是诊断心脏黏液瘤的有效方法;手术切除是心脏黏液瘤首选的治疗方法,一经确诊应尽快手术。     

Systemic septic embolisation secondary to an atrial myxoma in a young woman

We present a case of a left atrial myxoma infected with Staphylococcus aureus in a 35-year-old woman who was found to have a retained tampon. Multiple systemic septic emboli were seen on computed tomography imaging of the brain, spleen and kidneys. She was successfully treated by surgical excision of the myxoma and 4 weeks of antibiotic therapy. We postulate that the source of this patient’s S. aureus infection was tampon use, leading to a toxic shock syndrome and causing infection of an undiagnosed left atrial myxoma, which led to the embolisation. As far as the authors are aware, this is the first reported case of such an entity. In those with an underlying cardiac predisposition, tampon use may represent a risk of infection with S. aureus, and we intend to heighten clinical awareness of this potentially life-threatening association. We also discuss the diagnosis, complications and treatment of infected atrial myxoma and illustrate the imaging findings.     

Role of magnetic resonance imaging for evaluation of tumors in the cardiac region

The aim of this study was to review the role of MRI in the assessment of heart neoplasm, 25 cases with heart neoplasm (10 myxoma, 6 rhabdomyoma, 5 angiosarcoma, 2 mesothelioma, 1 lymphoma, and 1 fibroma) were examined with MRI and echocardiography. Multislice T1- and T2-weighted spin-echo images and static gradient-echo images were taken in appropriate directions with electrocardiogram gating. Gadolinium enhancement was performed in 21 cases. Transthoracic echocardiography was performed in all cases. Except for the 5 patients with rhabdomyoma, the pathological diagnosis was obtained. MRI proved to be useful for tissue characterization of myxoma, angiosarcoma, mesothelioma, and fibroma in cases with tuberous sclerosis. MRI also proved to be useful for detection of the tumor, depiction of contour, relation with other cardiac structures, in cases with myxoma, angiosarcoma, mesothelioma, lymphoma, and fibroma. In the differential diagnosis, MRI provided important information in cases with myxoma, rhabdomyoma, angiosarcoma, and fibroma. In cases with tumors expanding into the mediastinum, such as mesothelioma and fibroma in this report, MRI was useful in determining the location and border. In cases with tumors adjacent to pericardium, MRI was useful in detecting pericardial invasion. Gadolinium enhancement added useful information in cases with myxoma, rhabdomyoma, angiosarcoma, and mesothelioma. The role of MRI with and without Gd enhancement differs somewhat in individual types of heart neoplasm, and adaptation must be considered in each kind of neoplasm. On the other hand, MRI is an essential examination in all cases with a cardiac mass, which has not been diagnosed, since it may provide useful information for the differential diagnosis.     

川崎病巨大冠状动脉瘤的外科治疗(附5例报告)

目的探讨终末期川崎病(黏膜皮肤淋巴结综合征)合并冠状动脉瘤的临床特点、外科干预指征及手术方法。方法回顾性分析2006年5月-2007年10月经手术治疗的5例川崎病合并冠状动脉瘤患者的临床资料。患者年龄2～57岁,冠状动脉瘤体直径1·5～2·5cm,其中右冠状动脉多发冠状动脉瘤1例,左冠状动脉主干及前降支冠状动脉瘤2例,左、右冠状动脉瘤2例。术前心电图显示ST改变5例。心脏超声EF值明显减低4例,心衰急诊入院1例。冠状动脉造影右冠状动脉完全闭塞、心室壁运动幅度减低1例。手术方法包括体外循环直视下冠状动脉内膜剥脱、血栓清除、瘤体成形4例,其中1例同期行冠状动脉切口远端支架置入。另1例直接行冠状动脉搭桥术。结果无手术死亡,心脏全部自动复跳。术后ICU病程平稳,4例心电图ST段缺血改善、心脏超声EF值明显提高,1例ST段及EF值改善不显著。结论临床Ⅲ期以上川崎病合并冠状动脉瘤有明显临床症状者应外科干预,采用内膜剥脱、血栓清除、瘤体成形及冠脉搭桥等综合方法,结合术后抗凝及免疫治疗,可有效改善心肌缺血及心脏功能。     

升阳益胃汤联合双岐杆菌治疗食管贲门癌术后腹泻的临床疗效观察

目的 观察中西医结合治疗食管贲门癌术后腹泻患者的临床疗效.方法 选取2014年1月—2014年10月就诊于我院的食管贲门癌术后腹泻患者60例,随机分为治疗组和对照组各30例.对照组:口服或管喂双岐杆菌四联活菌片;治疗组:在对照组的基础上加用升阳益胃汤.结果 治疗组总有效率为90.0%,对照组有效率为66.7%,两组患者临床疗效比较有显著差异(P<0.05).结论 升阳益胃汤联合双岐杆菌能有效促进肠道功能的恢复,对食管贲门癌术后腹泻有较好的疗效.     

手术治疗125例分化性甲状腺癌的5年随访结果分析

目的：探讨甲状腺全切除术在治疗分化性甲状腺癌中的临床应用价值。方法：采用我院1988年1月～2001年5月甲状腺全切除术或甲状腺侧叶切除加峡部切除术治疗分化性甲状腺癌125例,对其手术并发症发生、局部复发、转移情况及术后5年生存率进行回顾性对比分析。结果：甲状腺全切除术术后并发症发生率高于甲状腺侧叶切除加峡部切除术组;局部复发、转移率低于侧叶切除加峡部切除术组;5年生存率两组无显著性差异。结论：甲状腺全切除术是治疗甲状腺癌有效的手术方式,但应掌握手术指征,改进、提高手术技术,减少并发症。     

Intramuscular myxoma: magnetic resonance features.

Magnetic resonance imaging (MRI) was performed in six cases of intramuscular myxoma of the extremities and revealed the following characteristics. All tumours were confined to muscle and had a sharply defined border. All had a signal intensity lower than skeletal muscles on T1-weighted images and brighter than fat on T2-weighted images. The signals were homogeneous on both T1- and T2-weighted images. This study did not include contrast enhancement. The diagnosis was confirmed by an open biopsy. All tumours were resected with no recurrence. Diagnosis based on these MRI characteristics was incorrect in two cases of intramuscular ganglia and in a case of intramuscular cysticercus cellulose. MRI features of intramuscular myxoma are typical in the majority of cases. Benign intramuscular lesions that contain mainly fluid can mimic intramuscular myxomas.     

支气管动脉栓塞治疗支气管扩张大咯血的技术探讨

目的:探讨支气管动脉栓塞(BAE)治疗支气管扩张大咯血的疗效。方法:31例支气管扩张大咯血患者,选择性支气管动脉造影明确咯血病灶后,对靶血管用明胶海绵颗粒及小条进行栓塞治疗,其中11例同时加用弹簧钢圈行多重栓塞治疗。所有病例门诊随访。结果:31例患者BAE术后30例咯血完全停止,即时止血率96.77%(30/31)。3例在栓塞术后1周内复发大咯血,1例再次行BAE治疗后咯血停止,2例改行手术治疗,近期复发率9.68%(3/31)。中、远期复发少量咯血2例,复发率为6.45%(2/31),总有效率93.55%(29/31)。结论:支气管动脉栓塞术治疗支气管扩张大咯血是一种安全、高效、简便、损伤小的治疗方法,采用多重栓塞可有效降低复发率。     

Imaging procedures in the detection of cardiac tumors,with emphasis on echocardiography: A review

Although cardiac tumors are relatively rare, their diagnosis is important because successful treatment is usually feasible if the diagnosis is made preoperatively. An analysis of 219 reports of cardiac tumors described in the English literature from 1972 through 1977 demonstrated the predominance of benign tumors, in particular myxoma, which is in agreement with past reviews. The methods of diagnosis employed included plain chest films, echocardiography, cardiac catheterization, angiocardiography, and cardiac scintigraphy. Conventional x-ray examination of the chest was abnormal in 83% of cardiac tumors but non-specific and should lead to further evaluation, first by echocardiography. Echocardiography, the most efficient diagnostic procedure for screening possible cardiac tumors, was abnormal in 94% of the cases. Cardiac catheterization was abnormal in 80% of cardiac tumors while definitive detection was made by angiocardiography in 94% of the cases. Cardiac scintigraphy has had limited use in the diagnosis of cardiac tumors, but has been diagnostic in 100% of the cases in a small series of myxomas.