147例原发心脏肿瘤外科治疗的近远期效果

Early and late results of surgical treatment for primary cardiac tumors

目的 总结原发心脏肿瘤外科治疗的近期及远期效果。方法 回顾 1984年 7月至 2 0 0 0年 12月 147例原发心脏肿瘤病人 ,按病理分为 3组 :粘液瘤 139例 ,男 5 8例 ,女 81例 ,年龄 5～ 72岁 ;非粘液瘤良性肿瘤 4例 ,男、女各 2例 ,年龄 15～ 42岁 ;恶性肿瘤 4例 ,男 1例 ,女 3例 ,年龄 2 3～ 6 2岁。手术后共随访 132例 ,随访率 92 .3%。结果 粘液瘤组 12 5例随访 3个月～ 17年 ,手术死亡率 2 2 %(3 139) ,远期死亡率 4 0 % (5 12 5 ) ,复发 5例 ,其中 4例为起源于左房房间隔以外的粘液瘤。非粘液瘤良性肿瘤病人均随访 ,7个月～ 8年 ,无手术和远期死亡。恶性肿瘤病人手术死亡 1例 ,余 3例分别于术后4、5、30个月死于肿瘤复发。结论 原发心脏肿瘤手术治疗的近远期效果取决于心脏肿瘤的病理类型 ,术后应重视复查。

Objective: To review the early and late results of surgical treatment for primary cardiac tumors. Methods: Between July 1984 and December 2000, 147 patients underwent operation for primary cardiac tumors. Tumors were grouped into three categories: myxomas, benign nonmyxomas, and malignant tumors. 136 patients (92 3%) were followed up. Results: 139 patients were diagnosed as myxomas (Male/Female: 58/81), average age (43 7±15 1) years. The hospital mortality rate was 2 2% (3/139), late mortality rate was 4%(5/125). Late recurrent rate was 4%(5/125). The site of myxomas was not at the atrial septums in four of the five recurrent patients. 4 patients were diagnosed with benign nonmyxomas tumors (Male/Female: 2/2), average age (32 8±12 5) years. There were no hospital death and recurrence. 4 patients were diagnosed as malignant tumors (Male/Female: 1/3), average age (42 3±20 6) years. The hospital mortality rate was 25% (1/4). The other three patients died at 4, 5, and 30 months after operation because of recurrence. Conclusion: Surgical resection is the treatment of choice for primary cardiac tumors. The results of surgical treatment are closely related to pathology of the tumors. A close postoperative long termed follow up and surveillance for these patients is recommended.