心脏肿瘤的诊断与外科治疗

目的:探讨心脏肿瘤的特点和外科疗效。方法:2000年1月至2008年12月,手术治疗56例心脏肿瘤患者,其中粘液性肿瘤48例(85.7%),左房粘液性肿瘤45例,右房粘液性肿瘤3例;累及右心房的下腔静脉平滑肌瘤4例(7.1%),均为良性;原发性恶性肿瘤4例(7.1%),均为肉瘤,包括左心房恶性间皮瘤2例,右心室梭形细胞肉瘤1例,右心房血管肉瘤1例。52例良性肿瘤均完整切除;4例恶性肿瘤中,完整切除2例,大部切除1例,因广泛侵润转移者只行活检1例。同期行二尖瓣成形术5例,二尖瓣替换术1例,房间隔缺损修补术3例,室间隔修补1例,三尖瓣成形术3例。结果:本组无围术期死亡,平均随访(33.46±11.35)个月,2例粘液瘤于3年内复发并手术,恶性肿瘤4例术后3个月至2年复发或转移死亡。结论:心脏肿瘤的疗效与病理性质和肿瘤生长部位密切相关。

Diagnosis and Surgical Management of Cardiac Tumor

Objective:To study the effect of surgical treatment of cardiac tumor.Methods:From January 2000 to December 2008,56 patients underwent surgical treatment for cardiac tumor,the histopathologieal diagnosis of the tumor was as follow:myxomas in 48(85.7%),benign intracardia leiomyomatosis in 4(7.1%).primary malignant tumors which were all sarcomas in 4(7.1%).52 cases of benign tumor had total tumor resection;among 4 cases of malignant tumor,2 patients had total tumor resection.1 patient had partial tumor resection and 1 patient had only biopsy.Other operations in the same stage included 5 cases of mitral valve repair,1 case of mitral valve replacement,3 cases of tricuspid valve repair.Results:There was no perioperative death.After a mean fllow-up time of(33.46±11.35) months after surgery.Conclusion:The efect of surgical treatment related to the histopathological diagnosis and the location of the cardiac tumor.