心内粘液瘤切除术后中期疗效观察  

Mid-term outcome of intracardiac myxoma resection

作　　者：张永 王鹏宇 陈柯 刘宇 张春振 兰怀 吕丽华 方敏华 ZHANG Yong;WANG Peng-yu;CHEN Ke;LIU Yu;ZHANG Chun-zhen;LAN Huai;LYU Li-hua;FANG Min-hua(Department of Cardiovascular Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院心血管外科,辽宁沈阳110016 [2]中国医科大学研究生院,辽宁沈阳110122

出　　处：《创伤与急危重病医学》2023年第5期332-335,共4页Trauma and Critical Care Medicine

基　　金：辽宁省自然科学基金医工交叉项目(2022-YGJC-12)。

摘　　要：目的 探讨心内粘液瘤切除术的中期疗效。方法 回顾性分析北部战区总医院心血管外科自2011年6月至2015年6月收治的146例行心内粘液瘤切除术的粘液瘤患者临床资料,其中,124例(84.9%)粘液瘤原发点位于左心房,16例(11.0%)粘液瘤原发点位于右心房,5例(3.4%)粘液瘤原发点位于右心室,1例(0.7%)粘液瘤原发点位于左心室。患者主要临床症状为呼吸困难,术前均行心脏超声检查,且经术后病理检查明确为粘液瘤。所有患者经胸骨正中开胸行外科手术治疗。结果 患者无院内死亡(成功率100.0%)。1例患者因术后愈合不良行二次清创缝合术。术后定期复查和随访,最终随访132例(随访率90.4%)。随访患者1、3年的术后累积生存率分别为99.3%、97.8%。存活患者美国纽约心脏病学会心功能分级为Ⅰ~Ⅱ级。结论 粘液瘤因附着部位不同可引起心力衰竭或动脉栓塞,应尽快手术切除。外科手术切除的安全性较高,术后应定期随访,常规复查超声心动图。Objective To investigate the med-term outcome of intracardiac myxoma resection.Method The clinical data of 146 patients with myxoma undergoing intracardial myxoma resection admitted to the Department of Cardiovascular Surgery of the General Hospital of Northern Theater Command from June 2011 to June 2015 were retrospectively analyzed.Among them,the primary site of myxoma was in the left atrium in 124 patients(84.9%),in the right atrium in 16 patients(11.0%),in the right ventricle in 5 patients(3.4%),and in the left ventricle in 1 patients(0.7%).The main clinical symptom of the patients was dyspnea.Cardiac ultrasonography was performed before the surgery,and myxoma was confirmed by pathological examination after the surgery.All the patients underwent midsternal thoracotomy for surgical treatment.Results There was no death in the hospital(survival rate was 100.0%).One patient underwent secondary debridement due to poor postoperative incision healing.All the patients were followed up at discharge and 132 patients(90.4%)were finally followed up.The cumulative survival rate at 1 and 3 years was 99.3%and 97.8%,respectively.Surviving patients were classified as GradeⅠto GradeⅡby cardiac functional grading of the New York Heart Association.Conclusion Myxoma may cause heart failure or pulmonary embolism due to different attachment sites.So it should be surgically removed as soon as possible.Surgical treatment is safe and effective.Regular follow-up and routine echocardiogram examination should be performed after the surgery.

关 键 词：粘液瘤 外科手术 中期疗效 随访 

分 类 号：R732.1[医药卫生—肿瘤]