93例心房黏液瘤的诊断与治疗

Diagnosis and treatment of 93 cases of atrial myxoma

目的:探讨心房黏液瘤的诊断和治疗方法。方法:研究统计93例心房黏液瘤患者,所有患者在体外循环下经右心房入路摘除黏液瘤。术中注意摘除瘤体要完整,适度去除瘤蒂周围的正常组织。如有合并瓣膜问题,注意同期处理。结果:体外循环时间31～440 min,平均45.2 min,主动脉阻断时间(10～250)min,平均27.2 min,实行左心房黏液瘤切除87例,右心房黏液瘤切除6例,围手术期死亡1例。术后随访3个月至2年,复发2例,余预后良好。结论:心房黏液瘤应积极早期手术治疗。保护瘤体完整性和同期处理心脏其它病变,摘除瘤体后维持心脏正常解剖是手术的关键。

Objective：To explore the diagnosis and the method of surgical treatment of atrial myxoma. Methods：93 cases of atrial myxoma treated surgically were investigated. All patients underwent excision of myxoma under cardiopulmonary bypass through right atrial. We removed the tumor completely, and normal tis- sue around stem of the tumor paying attention to Correct abnormal anatomy of cardiac during operation. Re- suits：The Cardiopulmonary bypass time was 31 -440 rain mean （45.2 ＋ 47.1 ） min. The time of blocking aorta was 10 -250 rain mean （27.2 ＋30. 5） rain. All of 87 cases of left atrial myxoma and 6 cases of right atrial myxoma were exercised successfully and one case died in perioperation. The patients had uneventful recovery and were asymptomatic, two patients relapsed after at least 3 months to 2 years of follow-up. Conclusion： Car- diac myxoma should be surgical treated energetically. The keys of the operation are protection of tumor Integri- ty, treatment of other anomalies of the heart simultaneously and maintenance the normal anatomy of the heart af- ter removal of the tumor.