原发性左心房恶性肿瘤的临床分析  

Clinical Analysis of Primary Malignant Tumors of the Left Atrium

作　　者：张旌[1] 黄志雄[1] 孙寒松[1] 许建屏[1] 王红月[1] 

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心外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2008年第3期174-177,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨原发性左心房恶性肿瘤的临床特征和外科治疗的远期效果。方法回顾性分析13例原发性左心房恶性肿瘤患者的临床资料,其中急诊手术1例,限期手术12例;左心房恶性肿瘤完整切除7例(53.8%),大部分切除3例(23.0%),因广泛浸润转移仅做活检2例(15.4%),同种异体心脏移植1例(7.7%)。结果无围手术期死亡;术后病理类型为间叶肉瘤5例,平滑肌肉瘤2例,粘液瘤恶变2例,血管肉瘤,纤维肉瘤,恶性纤维组织细胞瘤,恶性血管周围细胞瘤各1例。随访11例,随访时间3～65个月;死亡9例(69.2%),均在3个月至6年内死于复发或转移;2例失访。结论外科手术仍然是原发性左心房恶性肿瘤的主要治疗方法,手术不但切除了肿瘤组织,而且解除由肿瘤堵塞等所导致的临床症状,但远期效果仍较差。Objective To investigate the clinical characteristics of primary malignant tumors of the left atrium and the late results of surgical treatment. Methods The clinical experience with surgical treatment of 13 primary malignant tumors of left atrium was analyzed retrospectively. Complete resection of malignant tumor was achieved in 7 cases（53.8% ）,and subtotal resection was achieved in 3 cases（23.0%）, only biopsy was performed in 2 patients （15.4%）because of extensive metastasis of tumor. Heart transplantation was performed in 1 case（7.7 % ）. Results There was no hospital death. The pathological diagnosis was undifferentiated sarcoma in 5 cases, leiomyosarcoma in 2 cases, malignant transformation of myxoma in 2 cases, angiosarcoma in 1 case, fihrosarcoma in 1 case, malignant fibrous histocytoma in 1 case and malignant hemangiopericytoma in 1 case. There were 11 patients followed-up for 3 months to 65 months and showed 9 late death due to recurrence or metastasis. There was 2 patients lost of followup. Conclusion Primary malignant tumors of the left atrium should he resected to relieve symptoms caused by local tumor growth. Surgery provides control of primary tumor and allows the potential for cure or long-term survival with effective adjuvant therapy. The prognosis of these patients is still poor.

关 键 词：心脏肿瘤 左心房 心脏外科手术 

分 类 号：R732.1[医药卫生—肿瘤]