242例外科治疗的心脏肿瘤的临床分析

Clinical Analysis of Surgical Treatment on 242 Cases with Cardiac Tumors

目的:探讨心脏肿瘤临床特点,总结诊断和外科治疗经验。方法:对33108例心脏手术中242例心脏肿瘤的临床资料进行统计分析。结果:良性肿瘤214例(占88.4%),其中粘液瘤186例(占76.9%);恶性肿瘤28例(占11.6%),其中继发性心脏肿瘤8例。良性肿瘤最常见的是生长在左房,共178例(占良性肿瘤的83.2%)。外科治疗行急诊手术者96例(占39.7%)。全麻浅低温体外循环下实施手术233例,深低温低流量1例,深低温停循环2例,常温麻醉下6例。术中肿瘤全部切除者213例,部分切除27例,术后住院期间死亡1例。结论:外科治疗的心脏肿瘤多数为原发良性肿瘤,超声心动图是术前诊断心脏肿瘤的最佳手段,手术切除是治疗原发心脏肿瘤的首选治疗方法。

Objective： To analyze the clinical characteristics, diagnosis and surgical treatments of cardiac tumors. Methods： A total of 33108 cases receiving cardiac surgery from October of 1996 to March of 2005, were studied retrospectively and the data of 242 cases with cardiac tumor were reviewed and analyzed. Results： Among the 242 cases, 214 were benign tumors and the majority of them were myxomas; 28 were malignant tumors, with 8 secondary tumors among them. Emerging surgical procedures were conducted in 96 cases. The patients in 236 cases underwent surgery with cardiopulmonary-bypass （CPB）, and those in 6 cases underwent surgery without CPB. Complete resection was achieved in 213 cases and partial resection in 27. Only 1 patient died during hospitalization. Conclusions： Benign cardiac tumors are much more prevalent than malignancies in patients undergoing cardiac surgical treatment. Two-dimensional echocardiography and Doppler are the best way to locate the tumor and evaluate the valvular function. Surgical resection is the preferred choice for clinical therapy of cardiac tumors.