心脏肿瘤181例外科治疗的临床分析  

Surgical Treatment of Cardiac Tumors:Clinical Analysis of 181 Patients

作　　者：王咏[1] 肖颖彬[1] 陈林[1] 王学锋[1] 陈柏成[1] 陈劲进[1] 刘梅[1] 

机构地区：[1]第三军医大学新桥医院全军心血管外科研究所心血管外科,重庆400037

出　　处：《中国胸心血管外科临床杂志》2013年第2期155-158,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨心脏肿瘤的外科治疗方法,分析其临床治疗效果。方法回顾性分析1980年1月至2010年12月在第三军医大学新桥医院接受外科治疗181例心脏肿瘤患者的临床资料,其中男79例,女102例;年龄10个月～76岁(45.22±18.21)岁。179例患者在体外循环下行180次瘤体摘除术;2例恶性肿瘤仅施行开胸探查,瘤体未能切除,瘤体切除后进行病理分析。结果全组原发性心脏肿瘤169例(93.4%),其中粘液瘤144例(79.6%),其它原发性良性心脏肿瘤20例(11.0%),原发性恶性心脏肿瘤5例(2.8%);继发性心脏肿瘤12例(6.6%)。原发性心脏肿瘤患者围手术期死亡2例(1.1%),1例死于低心排血量综合征,1例死于术后多器官功能衰竭;5例原发性恶性肿瘤患者术后12个月内均死亡;良性肿瘤患者随访6个月～15年(2.41±1.08)年,无复发。继发性心脏肿瘤患者围手术期死亡1例,死亡原因为术后多器官功能衰竭;2例在术后1年内死亡,3例术后第3年死亡。结论粘液瘤是最常见的心脏肿瘤;外科手术彻底摘除瘤体是治疗心脏肿瘤的最佳方案;良性肿瘤的手术疗效明显好于恶性肿瘤,原发性恶性心脏肿瘤外科治疗效果较差。Objective To investigate surgical treatment strategies and analyze clinical outcomes of cardiac tumors. Methods Clinical data of 181 patients with cardiac tumors who underwent surgical treatment in Xinqiao Hospital of Third Military Medical University from January 1980 to December 2010 were analyzed retrospectively. There were 79 male patients and 102 female patients with their age of 10 months-76 years （45.22 ± 18.21 years）. A total of 179 patients underwent 180 tumor resection surgeries under cardiopulmonary bypass （CPB）. Two patients with malignant tumors did not receive surgical resection but exploratory thoracotomy. All the tumor specimens were examined by pathologists. Results There were 169 patients （93.4%） with primary cardiac tumors, including 144 patients （79. 6%） with myxoma, 20 patients （11.0%） with other types of primary benign cardiac tumors, and 5 patients （2.8%） with primary malignant cardiac tumors. There were 12 patients （6.6%） with secondary cardiac tumors. There were 2 perioperative deaths （1.1%） in patients with primary cardiac tumors, including 1 patient with low cardiac output syndrome and another patient with postoperative multiple organ dysfunction syndrome. All the 5 patients with primary malignant tumors died in postoperative 12 months. Patients with benign cardiac tumors were followed up for 6 months-15 years （2.41 ±1.08 years） without tumor recurrence. Among patients with secondary cardiac tumors, there was 1 perioperative death because of postoperative multiple organ dysfunction syndrome, 2 patients died within postoperative 1 year, and 3 patients died in the 3rd postoperative year during follow-up. Conclusion Myxoma is the most common cardiac tumor. Complete surgical resection is the best treatment strategy for patients with cardiac tumors. Clinical outcomes of patients with benign cardiac tumors are significantly better than those with malignant cardiac tumors. Prognosis of patients with primary malignant cardiac tumors is poor.

关 键 词：心脏肿瘤 诊断 外科治疗 

分 类 号：R732.1[医药卫生—肿瘤]