心脏原发肿瘤的临床表现和外科治疗

目的:总结 6 9例心脏原发肿瘤的临床表现及外科治疗经验 ,评价手术效果。方法 :6 9例中良性肿瘤 6 2例 ,恶性肿瘤 7例 ,均于体外循环下行心内直视手术。完整切除左心房肿瘤 5 4例 ;右心房肿瘤 11例 ,完整切除 6例 ,姑息性手术 5例 ;左心室肿瘤 1例 ,右心室肿瘤 2例 ,三尖瓣肿瘤 1例均于心脏停跳下完整切除。结果:6 9例病人无手术死亡。术后 1例左心房粘液瘤患者发生了脑栓塞 ,治疗后好转出院。6 9例随访 3个月～ 10年 ,6 2例心脏良性肿瘤均无复发 ,7例恶性肿瘤 3个月～ 1年死亡。结论 :心脏肿瘤临床表现差异很大 ,手术切除是治疗心脏肿瘤的首选方法 ;术后随访复查非常重要 ;心脏良性肿瘤手术效果很好 ,远期无复发 ;恶性肿瘤的预后欠佳。

Clinical characteristics and surgical treatment of primary cardiac tumors

Objective: To review clinical characteristics of primary cardiac tumors and assess the results of surgical treatment. Methods: 69 patients underwent operation for cardiac tumors by extracorporal circulation,Of 62 were benign tumors,of 7 were malignant tumors,tumors were grouped into five categories: (1) of 54 left artriums tumor were chosen complete surgical resection. (2) of 11 right artrium tumors,there were complete surgical resection in 6 patients,5 patients were chosen palliative procedure. (3) of 1 left ventricular tumor was lipoma. (4) of 2 right ventricular tumors,there was right ventricular benign myxoma in 1 patient,malignant myxoma in 1. (5) there was tricuspid teratoma in 1 patient. Results: There was no hospital death in 69 patients,all patients were followed up from 3 months to 10 years. Cardiac benign tumors had no recurrence. Patients with malignant tumors died in 3 months to 1 year. Conclusions: Surgical resection is the treatment of choice for cardiac tumors. A close postoperative following-up is recommended. The results of surgical treatment for benign tumors are excellent,but the results of surgical treatment for malignant tumor are dissatisfied.