28例心脏肿瘤患者的临床特点和外科治疗  

Clinical characteristics and surgical treatment of cardiac tumors in 28 patients

作　　者：李斌[1] 刘爱军[1] 司锐 杨明[1] 苏俊武[1] LI Bin;LIU Ai'jun;SI Rui;YANG Ming;SU Junwu(Department of Pediatric Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,P.R.China)

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏中心,北京100029

出　　处：《中国胸心血管外科临床杂志》2021年第2期208-213,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：北京市自然科学基金(7202040)。

摘　　要：目的总结心脏肿瘤的临床特点和外科治疗结果。方法回顾性分析2013~2019年我中心收治的28例诊断为心脏肿瘤患者的临床资料,其中男12例、女16例,年龄1个月至69岁,中位年龄11.5岁,体重39.0(4.8~100.0)kg。患者均在全身麻醉体外循环下行肿瘤切除术,术中切除肿瘤标本行病理学检查。结果原发性心脏肿瘤27例,继发性心脏肿瘤1例。原发性心脏肿瘤包括粘液瘤16例、横纹肌瘤5例、炎性肌纤维母细胞瘤3例、血管瘤2例、纤维瘤1例;继发性心脏软骨肉瘤1例。28例心脏肿瘤分布在29处,其中左心房14例,右心房3例,左心室1例,右心室7例,二尖瓣2例,三尖瓣2例。全组患者中6例有脑栓塞史,3例有周围血管栓塞史,3例有晕厥史。围术期及远期无死亡病例。25例患者行完全切除术,3例行部分切除术;心脏肿瘤切除经房间隔切口17例,经右室切口6例,经右房切口5例。随访中,2例粘液瘤复发,再次行手术切除,3例心脏肿瘤部分切除的患者复查过程中有2例残余肿瘤组织消失,1例残余肿瘤组织大小与出院时无变化。结论对于原发性良性心脏肿瘤,外科手术治疗效果好,但能否达到完全切除需要根据术中肿瘤的解剖位置决定。如出现全身栓塞和晕厥,应考虑心脏肿瘤因素。Objective To analyze the clinical characteristics and surgical treatment results of cardiac tumors.Methods Clinical data of 28 patients with cardiac tumors,who underwent cardiac surgery in our hospital from 2013 to 2019 were retrospectively reviewed.There were 12 males and 16 females.The median age was 11.5 years,ranging 1 month to 69 years;and the median weight was 39.0(4.8-100.0)kg.All patients underwent tumor resection under cardiopulmonary bypass with general anesthesia,and postoperative pathological analysis was performed.Results There were 27 patients with primary cardiac tumors and 1 patient with secondary cardiac tumor.Among the primary cardiac tumors,there were 16 myxomas,5 rhabdomyomas,3 inflammatory myofibroblastomas,2 fibroids and 2 hemangiomas.The secondary cardiac tumor was chondrosarcoma.A total of 28 cardiac tumors occurred in 29 locations,including 14 in the left atrium,3 in the right atrium,1 in the left ventricle,7 in the right ventricle,2 in the mitral and 2 in the tricuspid.Cerebral embolism occurred in 6 patients,peripheral vascular embolism in 3 patients,and syncope in 3 patients.There was no death during the perioperative period and in the long term follow-up.Complete resection was performed in 25 patients and partial resection was performed in 3 patients.During the follow-up,2 patients with myxoma received reoperation for recurrence.Among the 3 patients with partial resection,residual tumor tissue disappeared in 2 patients,and in the other patient,there was no change in the size of the residual tumor tissue during the follow-up compared to that at discharge.Conclusion Cardiac surgery is an effective method for patients with primary benign cardiac tumors.However,whether the cardiac tumor tissue can be completely removed depends on the anatomical location of the tumor during the operation.If there are systemic embolism events and syncope,the possibility of cardiac tumors should be considered.

关 键 词：原发性心脏肿瘤 继发性心脏肿瘤 外科手术 

分 类 号：R732.1[医药卫生—肿瘤]