原发性心脏心包肿瘤及瘤样病变的外科治疗

Surgical Treatment of Primary Cardiac and Pericardial Tumors

为探讨原发性心脏心包肿瘤的发病率及其特征，并评估其治疗方法。病例均经胸部Ｘ线、超声心动图、ＣＴ、ＭＲＩ和心导管检查，并经病理学检查证实诊断。２４例行手术治疗病人中，良性肿瘤２０例术后存活至今，其中１５例术后随访５～１５年无复发；４例恶性肿瘤中３例行部分切除，１例仅做病理学检查，均于术后４个月内复发或转移死亡。作者认为，原发性心脏心包良性肿瘤采用手术治疗常可获得良好结果，恶性肿瘤早期手术结合放疗可延长病人生命。

To study the characteristics and methods of surgical treatment for primary cardiac and pericardial tumors.Twenty-four patients in this series were all treated surgically.The anatomical distribution and pathological classification of the tumors were as follows;The benign tumors in 21 cases consisted of intracardiac myxoma in 18,and mesenchymoma of the infundibulum of right ventricle,hemorrhagic cyst of the leaflet of pulmonary valve and sub-epicardial lipoma like tumor in 1 each.The malignant tumors were mesotheliosarcoma of pericardium in 1 case,mesenchymosarcoma of left atrium in 1,sarcoma of left atrium and ventricle in 1 and cross-striated myosarcoma of both left and right ventricles in 1.Results:In the benign tumor group,one patient died of severe low cardiac output postoperatively.The other 20 were still living and well.Among them,15 showed no signs of recurrence 5-15 years after operation.In 4 patients with malignant tumor,3 had subtotal resection and 1 had only biopsy.They all died within 4 months postoperatively due to recurrence or metastasis.Conclusion:In cases of benign tumor,operation usually produces good results.As for cases of malignant tumor,earlier operation combined with radiotherapy can prolong life.