215例心脏黏液瘤外科手术并发症的防治

目的 总结心脏黏液瘤外科手术并发症的防治经验.方法 心脏黏液瘤患者215例,在全身麻醉、体外循环、心脏停跳下行心脏黏液瘤摘除术.结果 围手术期死亡2例,因术后发生严重低心排血量综合征,最终多脏器衰竭死亡.余213例均治愈出院.并发症：低心排血量综合征35例,二次开胸止血8例,心律失常30例（其中包括阵发性室上性心动过速20例及室性期前收缩10例）,无重要器官栓塞.随访200例,随访率为93.9％（200/213）,随访时间1～8年.200例中,1例死于肺癌;1例复发,经再次行心脏黏液瘤摘除术后治愈;余均无明显异常.结论 心脏黏液瘤的外科治疗有其特殊性,做好术前、术中及术后的防治措施可以减少心脏黏液瘤手术并发症的发生.

Prevention and treatment for complications of cardiac myxoma excision in 215 cases

Objective To summarize the prevention and treatment experience of complications of cardiac myxoma excision.Methods Cardiac myxoma excision were performed in 215 cases under general anesthesia,cardiopulmonary bypass and cardiac arrest condition.Results Two cases died from severe low cardiac output syndrome which eventually caused multiple organ failure.The remaining 213 cases were cured and discharged.Among 213 cases,low cardiac output syndrome occurred in 35 cases,re-open chest for bleeding was performed in 8 cases,30 cases in arrhythmia （including paroxysmal supraventricular tachycardia in 20 cases and ventricular premature in 10 cases）,no vital organs embolism occurred.Follow-up was done to 200 patients for 1-8 years with a follow-up rate of 93.9% （200/213）.In 200 cases,1 case died from lung cancer,1 case recurred and was cured after re-operation.The remaining patients had no obvious abnormalities.Conclusion As the particularity of surgical treatment of cardiac myxoma,it is essential to take prevention measures to reduce complications of cardiac myxoma excision in perioperative periods.