摘要
目的分析心脏黏液瘤患者的临床与超声特点,提高临床医生对该病的诊治水平。方法对1985年10月至2011年2月在北京协和医院住院的全部心脏黏液瘤患者64例的临床表现、超声特点和手术情况等进行回顾性分析。结果64例心脏黏液瘤患者中,女性40例,男性24例,年龄2~77(47±17)岁。主要临床表现包括心悸24例(38%)、气短23例(36%)、发热13例(20%)、胸闷11例(17%)、头晕10例(16%)、乏力10例(16%)、体质量下降10例(16%)、晕厥9例(14%)、下肢水肿8例(13%),以及血栓栓塞13例(20%),其中脑卒中7例(11%)和外周动脉栓塞6例(9%)。从症状出现至确诊时间为1d至9年(中位数为3个月)。64例患者中单发黏液瘤62例(97%),其中位于左心房者58例(91%)、右心房2例(3%)、右心室2例(3%);多发黏液瘤2例(3%),其中1例为Carney综合征。超声描述的肿瘤大小为(5.0±1.8)cm×(2.9±1.0)cm,手术所见肿瘤大小为(5.4±1.6)cm×(3.6±1.3)cm×(2.6±1.2)cm,最大径在两者间差异无统计学意义。心脏超声描述的瘤蒂部位与术中所见吻合度达97%。右心黏液瘤诊断时心功能NYHAⅢ级者为3例(3/4),高于左心黏液瘤患者[17%(10/58),P〈0.05]。结论心脏黏液瘤以左心房黏液瘤最为常见,其临床表现多样,心脏超声对心脏黏液瘤的诊断价值高。
Objective To summarize the clinical and echocardiographic features of cardiac myxomas. Methods The medical records of patients with diagnosis of cardiac myxomas who hospitalized in our department from October 1985 to February 2011 were analyzed. Results A total of 64 patients were enrolled [ 40 female, the mean age was 2 -77 (47 ±17)years]. The main complaints were palpitation (n = 24, 38%), short breath (n=23, 36%), fever (n = 13, 20%), chest tightness (n = 11, 17%), dizziness (n = 10, 16%), fatigue (n = 10, 16% ), weight loss (n = 10, 16% ), syncope ( n =9, 14% ), edema ( n =8, 13% ) ; and thrombus embolisms (n = 13, 20% ) , including stroke ( n =7, 11% ) and periphery artery embolism ( n = 6, 9% ). The interval from symptoms onset to diagnosis (surgical removal) ranged from 1 day to 9 years (median: 3 months). Single myxoma was detected in 62 (97%) patients (58 in left atria, 2 in right atria and 2 in right ventricle) and multiple myxomas were found in 2 (3%) patients and one patient was diagnosed as Carney syndrome. The mean size of tumor assessed by echocardiography was (5. 0 ±1.8 ) cm × ( 2. 9 ±1. 0) cm. All myxomas were surgically removed ( 54 patients received operation in our hospital and 10 patients were operated in other hospitals) and diagnosis was confirmed during operation and the mezm myxoma size obtained from operation was ( 5.4 ±1.6 ) cm × ( 3.6 ±1.3 ) cm ×( 2. 6 ±1.2) cm (P 〉 0. 05 vs. tumor size assessed by echocardiography). The locations of tumor stalks found by echocardiography were confirmed during surgei7 in most cases(97% ). Incidence of NYHA class HI diagnosis was more often in patients with right heart myxomas [3 cases(3/4)]than in patients with left atrium myxomas [ 17% (10/58), P 〈0. 05 ]. Conclusions Clinical manifestations of cardiac myxomas were various and non-specific. Echocardiography remains the most valuable diagnosis tool for patients with cardiac myxomas.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2012年第7期597-600,共4页
Chinese Journal of Cardiology