原发性心脏肿瘤的诊断和外科治疗

目的探讨原发性心脏肿瘤的临床特征及诊疗方法。方法回顾分析126例原发性心脏肿瘤的临床特点及诊治结果。结果121例良性肿瘤均行手术治疗,其中6例在第一次术后1~7年复发,再次手术后治愈,均长期存活;另5例恶性肿瘤中1例围术期内死亡,其余在10个月内死于进行性心力衰竭、心脏压塞和心脏破裂。结论原发性心脏肿瘤临床表现复杂多样,超声心动图、CT、MRI等检查是早期明确诊断的重要手段。良性肿瘤手术治疗效果良好;恶性肿瘤进展较快,应早期手术结合综合性治疗以改善预后。

Diagnosis and surgical treatment of primary cardiac tumors

Objective To study the clinical characteristics, diagnosis, and surgical treatment of primary cardiac tumors. Method The clinical features and surgical results in 126 cases (1971-2000) of primary cardiac tumors were analyzed retrospectively. Results Among the 121 patients with benign tumors were treated surgically, 6 had recurrence of the pathologically confirmed intracardiac myxoma in a period of 1 to 7 years after surgery, and all were cured after reoperation. Follow-up of these patients showed satisfying long-term survival. In the other 5 malignant cases, 1 died during the perioperative period, and the others died of progressive heart failure, cardiac tamponade and cardiac rupture, respectively, within 10 months after the final diagnosis. Conclusion The symptoms of primary cardiac tumor are diverse and complex, and echocardiography, CT, MRI are instrumental for a definite early diagnosis. In case of benign tumors, operation usually produces good results, but for malignant tumors characterized by rapid progression, earlier surgical removal in combination with other therapeutic modalities may improve the prognosis.