原发性心脏肿瘤的外科治疗

本文报道1978年1月至1991年11月收治的79例原发性心脏肿瘤,其中良性肿瘤76例,恶性肿瘤3例。良性肿瘤中有粘液瘤71例,左右心室脂肪瘤各1例,右心房神经纤维瘤、右心房平滑肌瘤和左心室纤维瘤各1例。恶性肿瘤有恶性粘液瘤、粘液肉瘤和淋巴肉瘤各1例。在体外循环下施行肿瘤切除术77例,部分切除1例,病理活检1例。住院期死亡3例,死亡率3.7%。诊断主要是依据超声心动图和多普勒,非粘液瘤患者有时需作 CT 和/或磁共振显象检查。

SURGICAL MANAGEMEMT OF PRIMARY CARDIAC TUMORS

From January 1978 to November 1991,seventy-nine cases of primary cardiac tumorwere operated.Among them seventy-one were myxoma,two of the left atrial myxomaswere malignant,another tumors were lipoma in 2,neurilemmoma in 1,lymphangioma,in 1,fibroma in 1 and lymphoma in 1.Presently,two-dimensional echocaudiography and Doppler are utilized as safereliable and noninvasive imagine modalities.Sometime need computed tomography andnuclear magnetic resonance.The tumors,pedicle and attachment atrial septum or the endothelium were excisedwith the aid of cardio-pulmonary bypass.The cardiac cavities were irrigated withsaline to remove all of the fragments.There were 3 early postoperative deaths with an overall mortality rate of 3.7%.Poatoperative follow-up revealed that all patients are living well and no late recurren-ces,except 2 cases of malignant tumors died of recurrence in the heart and one caseof benign myxoma died of metastatic malignant tumor.