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232例原发性心脏肿瘤临床分析

[Clinical analysis for 232 cases of primary heart neoplasms].

作者信息

Han Jin-song, An Jun, Yan De-min

机构信息

Department of Cardiac Surgery, First Affiliated Hospital of China Medical University, Shenyang 110001, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2006 Jan 15;44(2):87-9.

PMID:16620663
Abstract

OBJECTIVE

To summarize the clinical characterizations and outcome of surgical treatment of primary heart neoplasms.

METHODS

The clinical data of cardiac neoplasms were analyzed retrospectively in 232 patients. There were 14 malignant tumors (6.0%) and 218 benign tumors (94.0%), of which 200 were left atrial myxomas (86.2%). Palpitation and dyspnea on exertion added up to 87.1% (202/232) of all clinical symptoms. Two hundred and twenty-three out of 230 patients underwent complete removal of the tumors, remaining 2 patients had partial removal. Five patients received biopsy only. Other procedures had done in the same stage including 5 cases with mitral valve replacement, 1 case with pulmonary arterial valve replacement, 5 cases with thrombectomy through the Fogarty catheter.

RESULTS

Two cases died preoperatively operation. Three cases died intraoperative operation. One hundred and eighty-five cases were followed up for 6 months to 24 years, of which 10 malignant tumors died in 1 year and 1 malignant case recurred after 4 months. Of 174 benign neoplasms, 1 case recurred and 10 cases were dead, remaining were cured.

CONCLUSIONS

Left atrial myxomas are most commonly seen in patients with primary heart neoplasms. Palpitation and dyspnea on exertion are the most frequent symptoms. It is suggested that the patients should accept surgical treatment as soon as possible once the diagnosis is confirmed. Surgical treatment is effective for the benign cardiac tumors. Prognosis is poor in patients with malignant cardiac tumors.

摘要

目的

总结原发性心脏肿瘤的临床特征及外科治疗结果。

方法

回顾性分析232例心脏肿瘤患者的临床资料。其中恶性肿瘤14例(6.0%),良性肿瘤218例(94.0%),其中左房黏液瘤200例(86.2%)。心悸和劳力性呼吸困难占所有临床症状的87.1%(202/232)。230例患者中223例行肿瘤完整切除,2例部分切除。5例仅行活检。同期还进行了其他手术,包括二尖瓣置换5例、肺动脉瓣置换1例、经Fogarty导管取栓5例。

结果

2例术前死亡。3例术中死亡。185例随访6个月至24年,其中10例恶性肿瘤在1年内死亡,1例恶性肿瘤在4个月后复发。174例良性肿瘤中,1例复发,10例死亡,其余治愈。

结论

左房黏液瘤是原发性心脏肿瘤中最常见的类型。心悸和劳力性呼吸困难是最常见的症状。建议一旦确诊,患者应尽早接受手术治疗。手术治疗对良性心脏肿瘤有效。恶性心脏肿瘤患者预后较差。

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1
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Zhonghua Wai Ke Za Zhi. 2006 Jan 15;44(2):87-9.
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