心脏肿瘤外科治疗经验总结  

Experiences in surgical treatment of cardiac tumors

作　　者：胡盛寿[1] 王小啟[1] 许建屏[1] 孙立忠[1] 刘迎龙[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院外科,北京100037

出　　处：《中华医学杂志》2006年第11期766-770,共5页National Medical Journal of China

摘　　要：目的总结心脏肿瘤的外科治疗经验。方法回顾分析中国医学科学院阜外心血管病医院近30年494例心脏肿瘤的资料，年龄43岁±16岁（4个月～78岁），其中黏液瘤432例，非黏液性良性肿瘤27例，恶性肿瘤35例。结果黏液瘤手术死亡11例（病死率2．5％），非黏液性良性肿瘤无死亡，恶性肿瘤手术死亡3例（病死率8．6％）。对1990年1月到2004年7月黏液瘤手术患者241例进行随访，失访17例，随访率为92．9％，平均随访70个月±36个月；远期死亡10例，5例死于复发，5例原因不明。恶性肿瘤完整切除10例（28．6％），大部分切除15例（42．9％），因广泛浸润转移仅做活检者10例（28．6％）；平均随访时间为21个月±12个月（4～38个月）；死亡18例（51．4％），均在3个月至2年内死于复发或转移；5例失访。结论外科治疗心脏良性肿瘤具有很好的近期和远期效果，恶性肿瘤外科治疗效果极差。Objective To summarize the experiences in surgical treatment of cardiac tumors. Methods The results of surgical treatment of 494 patients with cardiac tumors hospitalized from 1975 to 2004, aged 43 ± 16 （4 months to 78 years）, 432 with myxoma, 27 with benign nonmyxoma, and 35 with malignant tumors, were analyzed. Results Complete resection of malignant tumor was achieved in 10 cases （28.6%）, and subtotal resection was achieved in 15 cases （42.9%）. or partial resection was performed based on the intra-operative condition. Only biopsy was performed in 10 patients （28.6%） because of extensive metastasis of tumor. Hospital death occurred in 11 myxoma patients （2.5%）, and 3 malignant tumor patients （ 8.6% ）, and none of the benign non-myxoma tumor patients. The patients were followed up for 70 ± 36 months with a follow-up rate of 92.9%. Late follow-up was performed for the 241 patients with myxoma who had underwent resection after 1990. Seventeen patients were lost to follow-up. There were 10 late deaths, 5 resulting from recurrence and 5 from unknown causes. Follow-up for malignant tumors showed 18 （51.4%） late deaths because of recurrence or metastasis, occurring 2 months to 2 years after operation. Conclusion Excellent immediate and long-term operative results can be obtained for benign cardiac tumors. However, for the patients with malignant tumors the survival chances are dismal.

关 键 词：心脏肿瘤 外科手术 

分 类 号：R732.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]