婴幼儿和儿童心脏肿瘤的临床特点和超声诊断的应用价值  

Diagnostic value of echocardiography for cardiac tumors in infancy and childhood

作　　者：周维新[1] 王浩[1] 阮英卯[2] 闫军[3] 魏以桢[3] 刘迎龙[3] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院超声科,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院病理科,北京100037 [3]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院外科,北京100037

出　　处：《中华儿科杂志》2005年第10期758-761,共4页Chinese Journal of Pediatrics

摘　　要：目的评价婴幼儿及儿童心脏肿瘤的临床特点、手术所见、病理学类型、以及治疗情况;评价超声心动图诊断婴幼儿及儿童心脏肿瘤的准确性.方法 1983年12月至2003年12月在北京阜外心血管病医院手术和病理证实为心脏肿瘤的患者19例,男8例,女11例;年龄5个月～14岁,平均(7±5)岁.结果 19例患者中,良性肿瘤17例(89.5%),其中黏液瘤10例(52.6%),横纹肌瘤4例(21.1%),纤维瘤2例(10.5%),脂肪瘤1例(5.3%);恶性肿瘤2例(10.5%),其中横纹肌肉瘤和转移性上皮肉瘤各1例.19例肿瘤中,11例位于左心(57.9%),7例位于右心(36.8%),1例位于双心室(5.3%).术前超声10例诊断黏液瘤和1例怀疑横纹肌瘤与术后病理结果一致(11/19,57.9%),其余8例因超声缺乏经验,诊断为心脏占位病变性质待定或黏液瘤可能性大(8/19,42.1%).结论婴幼儿和儿童心脏原发肿瘤多为黏液瘤,其次为横纹肌瘤,纤维瘤和脂肪瘤.黏液瘤多见于较大儿童,横纹肌瘤多见于婴幼儿,可呈多发性生长.当临床表现严重并难以控制时应选择手术.Objective The present study was designed to evaluate the clinical manifestations, surgical fndings, pathologic types and treatment of cardiac tumor and to analyze the echocardiographic characteristics of the cases. Methods Records of 19 patients with cardiac tumors confirmed by operations and pathology at Fuwai Cardiovascular Hospital in Beijing, China between Jan, 1983 and Dec, 2003 were reviewed. Clinical and echocardiographic data of all patients were analyzed. Results The median age of patients was 7± 5 years, ranging from 5 months to 14 years. There were 8 male and 11 female cases. The surgical findings revealed that 57. 9% （11 cases） of cardiac tumors were found in left heart , 36. 8% （7 cases） in right heart, 5. 3% （1 case）in two ventricles. The pathological study revealed that 17 cases （89. 5% ） were diagnosed as primary cardiac benign tumors including myxoma in 10 cases （52. 6% ）, rhabdomyoma in 4 cases （21.1%）, fibroma in 2 cases （10. 5% ） and lipoma in 1 case （5.3%）. Two cases were diagnosed （ 10. 5% ） as cardiac malignant tumors including a primary cardiac rhabdomyosarcoma and a metastatic epithelioid sarcoma. By using echocardiography 11 cases were diagnosed as myxomas and rhabdomyoma （ 11/19, 57.9% ） , 8 cases were diagnosed as space occupying lesions of the heart or myxoma （8/19, 42. 1% ）. Conclusions Myxomas are the most common heart tumors seen in infancy and childhood, followed in frequency by rhabdomyomas, fibromas and lipomas. Surgery is recommended for patients with refractory and severe clinical symptoms.

关 键 词：超声心动描记术 心脏肿瘤 婴儿 儿童 

分 类 号：R732.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]