肺癌心脏转移21例临床治疗效果观察

1993年9月至1994年12月间我院共收治79例晚期肺癌患者，其中发现肺癌心脏转移21例。上述病例均经组织学、细胞学确诊。肺癌心脏转移早期，无典型心瓣股或心包病变的临床表现。临床上出现的症状多与转移癌在心脏受累的部位和范围有关，多数病人病情迅速恶化。由于肺癌心脏转移已属癌肿晚期，除积极支持和对症处理外，同时进行全身和局部化疗。大量心包积液出现心包填塞征象者给予心包穿刺放液，心包腔内注入地塞米松和倾钠等措施，个别病例则行心包切开引流术。本组15例病人平均存活期9个月，而未经治疗者一般仅能存活3个月。如何早期发现心脏转移癌和提高生存期，尚待进一步探索。

Lung Cancer with Cardiac Metastasis (Results of Treatment in 21 Cases)

Among 79 cases of late lung cancer treated in our hospital from September 1993 to April 1994, cardiac metastasis were found in 21 cases. All diagnosis were confirmed by cytological examination. In the early stage, there were no typical valvular or pericardial symptoms. Clinical manifestations depended on mainly the location and extent of the cardiac involvement. However,most of the cases deteriorated rapidly. In addition to supportive and symptomatic treatments,chemotherapy,either systemic or topical was also important. Massive pericardial effusion with symptoms of cardiac tamponade required pericardial paracentesis. Intrapericardial injection of dexamethasone and cisplatin may lessen pericardial effusion.lncision and drainage of pericardium may be indicated in selected cases. The average time of survival of 15 cases thus treated was 9 months, wherease nonetreated cases survived less than 3 months. How to discover the presence of cardiac metastasis and to increase the survival time remain furture investigation.