原发性心脏肿瘤32例临床分析

目的总结原发性心脏肿瘤外科诊治的经验.方法自1982年1月至2003年12月,32例原发性心脏肿瘤患者接受外科治疗,全部病例术前经超声心动图确诊,术后经组织学检查证实为左房黏液瘤29例,右房血管肉瘤2例,右室血管瘤1例.均在体外循环下行心脏肿瘤摘除术.结果无围手术期死亡,8例术后发生低心排,1例发生呼吸衰竭,1例右房血管肉瘤术后2年原位复发再次手术治疗.结论原发性心脏肿瘤一旦确诊应立即手术治疗,且效果良好.超声心动图对原发心脏肿瘤的诊断有重要作用,自体心包可用于房隔修补和房壁重建.

Clinical report of primary cardiac tumors in 32 patients

Objective To review the experience of surgical treatment of primary cardiac tumors.Methods From Jan.1982 to Dec.2003, 32 patients with primary cardiac tumors underwent surgical treatment .The preoperative diagnosis was established with echocardiography and the diagnosis was confirmed postoperatively by histological study in all patients,in which the myxomas located in left atrium were found in 29 patients, the angiosarcomas located in right atrium in 2 patients and the hemangioma located in right ventricle in 1 patient.All patients underwent excision of tumors under cardiopulmonary bypass.Results There was no perioperative mortality.Low cardiac output syndrome occurred in 8 patients after operation and respiratory failure occurred in 1 patient after operation. There was one recurrence of right atrial angiosarcoma after 2 years and the reoperation was performed in this case.Conclusions Patients with primary cardiac tumors should undergo operation as soon as possible. Surgical resection is the only effective therapeutic option. Echocardiography plays a very important role in the diagnosis for patient with primary cardiac tumor. Autologous pericardium can be used for the repair of atrial septum and artial wall reconstruction.