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[十例原发性心脏瓣膜肿瘤的临床分析]

[Clinical analysis of ten primary cardiac valve tumors].

作者信息

Huang Zhi-xiong, Sun Li-zhong, Du Ming, Wang Hong-yue

机构信息

Department of Cardiovascular Surgery, Cardiovascular Institute, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100037, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2004 Feb 22;42(4):230-2.

Abstract

OBJECTIVE

To investigate the clinical characteristics of primary valve tumors and the late surgical results of their resection.

METHODS

We reviewed our clinical experience with the surgical treatment of ten primary valve tumors at Fuwai Hospital between November 1983 and November 2002.

RESULTS

In this series, cardiac valve tumors constituted 2.65% (10/378) of all primary cardiac tumors, and the incidence of primary valve tumors was roughly one in 4000 cardiac operations. There were 5 male and 5 female patients aged 2 to 66 years (mean age, 30 years). The clinical presentations included exertional dyspnea in 7 patients, neurological symptoms in 2, and cyanosis at rest in 1 patient. The diagnosis was established by preoperative echocardiography in 8 patients, and in the other 2, it was confirmed by the findings at operation. All of the tumors were resected. Eight of the ten tumors were benign, and two were malignant. All patients survived the operation and recovered eventfully. Late outcomes were known for all patients. There were three late deaths. One patient with a benign tricuspid valve died 2 months postoperatively of an electrolyte disorder. The other 2 patients with a malignant mitral valve tumor died within 1 year postoperatively. The 7 survivors, all with a benign valve tumor, were followed up for an average of 5.7 years (range, 8 months to 19 years), and all were in functional Class I. Exercise tolerance improved to normal levels. The latest follow-up echocardiography showed no evidences of the local recurrence in any patients.

CONCLUSION

Excellent early and late surgical results can be obtained in patients with benign valve tumors. The prognosis for the patients with a malignant valve tumor is poor.

摘要

目的

探讨原发性瓣膜肿瘤的临床特征及其切除术后的远期手术效果。

方法

回顾1983年11月至2002年11月期间阜外医院对10例原发性瓣膜肿瘤进行手术治疗的临床经验。

结果

在本系列中,心脏瓣膜肿瘤占所有原发性心脏肿瘤的2.65%(10/378),原发性瓣膜肿瘤的发病率约为每4000例心脏手术中有1例。患者共10例,男女各5例,年龄2至66岁(平均年龄30岁)。临床表现包括7例劳力性呼吸困难、2例神经症状和1例静息时发绀。8例患者术前经超声心动图确诊,另外2例经手术所见证实。所有肿瘤均被切除。10例肿瘤中8例为良性,2例为恶性。所有患者手术存活且恢复良好。所有患者均有远期随访结果。有3例远期死亡。1例良性三尖瓣瓣膜病患者术后2个月死于电解质紊乱。另外2例恶性二尖瓣肿瘤患者术后1年内死亡。7例存活者均为良性瓣膜肿瘤,平均随访5.7年(范围8个月至19年),心功能均为Ⅰ级。运动耐量恢复至正常水平。最新的随访超声心动图显示所有患者均无局部复发迹象。

结论

良性瓣膜肿瘤患者可获得良好的早期和远期手术效果。恶性瓣膜肿瘤患者预后较差。

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