1106例心脏粘液瘤患者的临床特征分析及术后复发因素研究  

Clinical characteristics and postoperative recurrence factors of 1106 patients with cardiac myxoma

作　　者：周明阳[1] 杨秀滨 华琨[1] 毛斌[1] 张良 孙东[1] 吴强[1] ZHOU Mingyang;YANG Xiubin;HUA Kun;MAO Bin;ZHANG Liang;SUN Dong;WU Qiang(Department of Cardiovascular 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心外科,北京100029

出　　处：《中国胸心血管外科临床杂志》2022年第10期1337-1341,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的总结1106例心脏粘液瘤患者的临床资料特征及手术治疗的经验。方法回顾性分析2002—2018年在北京安贞医院接受手术治疗的1106例心脏粘液瘤患者的临床资料,其中女749例(67.7%)、男357例(32.3%)。结果51~70岁患者最多。发病部位依次为:左心房987例(89.2%)、右心房99例(9.0%)、左心室10例(0.9%)、右心室8例(0.7%)。纽约心脏协会心功能分级Ⅰ~Ⅱ级1013例、Ⅲ~Ⅳ级93例。合并脑梗死301例、合并周围动脉栓塞57例。肿瘤大小与心脏血流动力学受影响症状密切相关(P≤0.05),与周围血管栓塞无明显相关关系(P>0.05)。住院死亡2例(0.2%)。术后随访306例,随访率27.7%。中位随访时间7(1~18)年,全因死亡1例,23例复发,复发率2.1%。复发病例中,非典型粘液瘤15例(65.2%)、典型粘液瘤8例(34.8%)。复发患者再次手术与1083例非复发患者手术相比,主动脉阻断时间、ICU监护时间、呼吸机辅助呼吸时间、术后住院时间、术后死亡率、出院时心脏射血分数等差异无统计学意义。结论心脏粘液瘤多见于女性,发病年龄多为51~70岁,好发于左心房,肿瘤大小可影响心脏血流动力学变化,外科手术治疗效果良好。复发病例中,非典型粘液瘤多见,通过手术治疗效果满意。Objective To summarize the clinical characteristics and surgical treatment experience of 1106patients with cardiac myxoma.Methods Clinical data of 1106 patients with cardiac myxoma who underwent surgical treatment in Beijing Anzhen Hospital from 2002 to 2018 were retrospectively analyzed.There were 749(67.7%)females and 357(32.3%)males.Results The highest incidence rate was at the age of 51-70 years.The location of the disease was:left atrium in 987(89.2%)patients,right atrium in 99(9.0%)patients,left ventricle in 10(0.9%)patients,right ventricle in8(0.7%)patients.There were 1013 patients of heart classification(NYHA)Ⅰ-Ⅱand 93 patients ofⅢ-Ⅳ.There were 301patients with cerebral infarction and 57 patients with peripheral arterial embolism.Tumor size was closely related to hemodynamic symptoms(P≤0.05),but not to peripheral vascular embolism(P>0.05).Two(0.2%)patients died in hospital and 306 patients were followed up,with a follow-up rate of 27.7%.The median follow-up time was 7 years(range,1-18 years).One patient died of all causes,and 23 patients recurred,with a recurrence rate of 2.1%.Among 23 recurrent patients,15(65.2%)patients were atypical myxoma and 8(34.8%)patients were typical myxoma.There was no statistical difference in aortic clamping time,ICU stay time,ventilator-assisted breathing time,postoperative hospital stay time,postoperative mortality,or cardiac ejection fraction at discharge between the reoperation in 23 recurrent patients and the first operation in 1083 non-recurrentpatients.Conclusion Cardiac myxoma is more common in middle-aged and elderly women,and it often occurs in the left atrium.The size of cardiac myxoma can affect the hemodynamic changes.Surgical treatment is effective.Atypical myxoma is more common in recurrent patients,and the effect is still satisfactory through surgical treatment.

关 键 词：心脏粘液瘤 心脏手术 复发 

分 类 号：R732.1[医药卫生—肿瘤]