原发性左心室良性肿瘤发生部位特点及手术效果分析  

Characteristics and surgical treatment of primary benign tumor of left ventricle

作　　者：苏文君[1] 宋民[1] 孟刘坤[1] 王水云[1] 许建屏[1] SU Wenjun;SONG Min;MENG Liukun;WANG Shuiyun;XU Jianping(Department of Cardiosurgery,Fuwai Hospital,Union Medical University,Chinese Academy of Medical Sciences,Bejing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院成人心脏外科中心,100037

出　　处：《心肺血管病杂志》2021年第1期43-47,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结原发性左心室良性肿瘤病理类型、发生部位特点及其手术治疗效果。方法:回顾性分析阜外医院2008年1月至2019年3月,收治的29例原发性左心室良性肿瘤患者临床资料,其中男性15例、女性14例,平均年龄(30.27±16.65)岁。分析不同类型肿瘤在左心室分布位置及手术效果。患者术后6个月返院复查超声心动图,以后经电话随访观察。结果:29例原发性左心室良性肿瘤,其中27例在全麻低温体外循环心脏停跳下行肿瘤切除术,2例心外膜下脂肪瘤在全麻常温非体外循环下行摘除术。9例患者肿瘤部分切除,其中6例脂肪瘤,2例横纹肌瘤,1例神经鞘瘤;20例患者肿瘤完整切除。无住院死亡及严重并发症,住院天数(7.93±2.69)d。随访结果:术后6个月,29例患者复查超声心动图正常。随访时间(62.69±38.54)个月,随访率93.1%。部分切除的9例患者中2例复发,神经鞘瘤和二次手术左心室腔内脂肪瘤各1例。结论:手术切除是治疗原发性左心室良性肿瘤的首选方法。除横纹肌瘤外,原发性左心室良性肿瘤需要早期发现,尽早手术。根据肿瘤的类型和位置制定安全、有效的手术方案,可以取得良好的治疗效果。Objective:To summarize the pathological types of primary left ventricular benign tumor,the characteristics of its location in the left ventricle,and its influence on preoperative diagnosis and surgical treatment effect.Methods:The clinical data of 29 patients with primary left ventricular benign tumor treated in Fuwai Hospital from January 2008 to March 2019 were retrospectively analyzed,including 15 males and 14 females,with an average age of(30.27±16.65)years.The clinical manifestations,diagnosis,specific distribution of different tumors in left ventricle,surgical method and cardiac incision were analyzed.The patients returned to the hospital to review echocardiography within 6 months after operation,and then followed up by telephone.We summarized the characteristics of different pathological types of primary left ventricular benign tumor and the location of occurrence,as well as the influence on preoperative diagnosis,surgical method and surgical treatment effect.Results:Twenty-nine patients were primary benign left ventricular mass.Twenty-seven patients were operated under general anesthesia,hypothermia and cardiopulmonary bypass(CPB),two patients with epicardial lipoma underwent normothermic surgery without CPB.Tumors were partially removed in 9 patients,including 6 cases of lipoma,2 cases of rhabdomyoma and 1 case of schwannoma.20 cases of tumors were completely removed.There was no hospital death and other complications.The postoperative hospital stay was(7.93±2.69)days.Follow up result:within 6 months after operation,29 patients returned to the hospital for reexamination.Subsequently,27 patients were followed up by telephone or outpatient service,2 cases were lost,the follow-up rate was 93.10%.The average follow-up time was(62.69±38.54)months.Two patients with partial resection recurred,including one case of schwannoma which recurred 30 months later,and one case of reoperation of lipoma,which enlarged 15 months later,led to massive mitral regurgitation.Conclusions:surgical resection is the first choice

关 键 词：原发性心脏良性肿瘤 左心室 心脏外科手术 发生部位 

分 类 号：R54[医药卫生—心血管疾病]