心脏原发性恶性肿瘤的诊断与治疗  

Diagnosis and Surgical Treatment of Primary Cardiac Malignant Tumors

作　　者：宋士秋[1] 王圣[1] 李温斌[1] 张健群[1] 周其文[1] 郭海平[1] 史海峰[1] 

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中国胸心血管外科临床杂志》2009年第2期90-93,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨心脏原发性恶性肿瘤的诊断和治疗方法,以提高诊疗水平。方法2004年4月～2008年6月,共19例心脏原发性恶性肿瘤患者在我科接受诊断及治疗,其中男11例,女8例;年龄17～64岁(40.7±12.1岁)。术前临床诊断:心脏占位性病变,原发性恶性肿瘤。在全身麻醉体外循环下完整切除肿瘤3例,部分切除1例,行同种异体心脏移植1例,开胸探查取活组织检查5例;9例(47.4%)患者失去了手术治疗的机会。结果全组无围手术期死亡。住院时间9～15d(10±7d),均顺利出院。术后发生心包积液2例,发热1例,均经对症治疗治愈。术后病理检查:平滑肌肉瘤1例,恶性间皮瘤1例,血管内皮肉瘤8例。随访14例(73.7%),随访时间1～38个月,死亡14例(73.7%),死于肿瘤复发或远处转移,失访5例(26.3%)。结论心脏原发性恶性肿瘤预后差,尽早明确诊断,尽可能完整地切除肿瘤可改善患者的生存质量。Objective To investigate the diagnosis and treatment methods of primary cardiac malignant tumors,so as to improve its＇ level of diagnosis and treatment. Methods From April 2004 to June 2008, 19 patients with primary cardiac malignant tumors were diagnosed and treated in the department of cardiac surgery in this hospital. Male 11, Female 8. Age of the patients was 40.7±12.1 years（17-64 years）. Preoperative diagnosis were occupying lesion in cardiac, malignant tumors were possible. Complete resections of malignant tumors were achieved by cardiopulmonary bypass （CPB） in 3 cases, and partially resected in 1 case, heart transplantation was performed in 1 case, only biopsies were performed in 5 cases. 9 cases （47.4%） lost the chances of operative treatments. Results There were no operative and hospital stay deaths. Hospital stay was 10 ± 7 d（9-15 d）, all patients were safely discharged from hospital. Two cases suffered from postoperative pericardial effusions,and high temperature happened in 1 patient, these 3 cases recovered by puncture and symptomatic treatment. The pathological diagnosis： leiomyosarcoma in 1case, malignant mesothelioma in 1 case and hemangioendothelial sarcoma in 8 cases. 14 cases （73.7%） were followed up from 1 to 38 months, 14 cases died of tumor recurrence or metastasis, the mortality was 73.7%, 5 cases （26.3%） were failed to be followed up. Conclusion The prognosis of patient with primary cardiac malignant tumor is still poor. Earlier diagnosis and complete surgical removal of the tumor as soon as possible may improve the patients＇qualities of lives.

关 键 词：心脏 恶性肿瘤 诊断 外科治疗 

分 类 号：R732.1[医药卫生—肿瘤]