32例心脏黏液瘤围术期临床特点分析

Perioperative features of cardiac myxoma in 32 cases

目的探讨心脏黏液瘤围术期临床特点。方法 32例心脏黏液瘤患者,其中6例合并栓塞者为栓塞组,无栓塞症状患者26例为未栓塞组,回顾性分析32例患者围术期的临床资料,对其人口学资料、肿瘤特点、实验室检查、手术相关资料进行总结分析。结果本组患者年龄(51.8±15.0)岁,男、女比例约为1∶1.9;32例均为单发心房黏液瘤,其中肿瘤位于左心房28例,右心房4例;红细胞沉降率[(29.33±25.44)mm/h]、C-反应蛋白[(12.55±10.04)mg/L]高于正常;栓塞组血小板计数[(302.8±48.3)×109/L]明显高于未栓塞组[(215.9±50.6)×109/L](P<0.05),年龄、性别比例、红细胞沉降率、C-反应蛋白、白细胞计数、血红蛋白、凝血酶原时间、体外循环时间、阻断时间、机械通气时间和ICU停留时间与未栓塞组比较差异无统计学意义(P>0.05);26例行单纯肿瘤切除术,同期行二尖瓣成形术2例,行三尖瓣成形术4例,行冠状动脉旁路移植术1例,体外循环时间为(72.39±30.14)min,阻断时间(47.91±26.39)min,机械通气时间(16.00±6.35)h,ICU停留时间(1.53±0.54)d;术后均无严重并发症发生,术后恢复均良好。结论心脏黏液瘤发病有明显性别差异,女性高于男性;部分患者血小板计数增多可能与栓塞事件发生相关;外科手术治疗安全、有效。

Objective To summarize the clinical perioperative characteristics of cardiac myxoma. Methods In 32 patients with cardiac myxoma, 6 patients were complicated embolism （embolism group） and 26 patients were not complicated with embolism （non-embolism group）. The clinical perioperative data were retrospectively analyzed summarize the demography data, oncologic features, laboratory examination and operation-related data. Results The patients were （51.75 ± 15.01 ） years old. The proportion of male and female was 1 ： 1. 9. All tumors of 32 patients were single, of which 28 were located in left atrium and the other 4 were located in right atrium. The erythroeyte sedimentation rate （（29.33 ± 25.44） mm/h） and C reactive protein （（12.55± 10.04） mg/L） were much higher than normal values. The platelet count was significantly higher in embolism group （（302.8±48.3） × 10^9/L） than that in non-embolism group （（215.9±50.6） ×10^9/L） （P〈0.05）. There were no significant differences in the age, proportion of male and female, erythrocyte sedimentation rate, C-reactive protein, platelet count, hemoglobin, prothrombin time, extracorporeal circulation time, blocking time, mechanical ventilation time, and ICU stay between two groups （P〉0. 05）. All patients recovered well after tumor resection in 26 patients, bicuspid valvoplasty in 2 and tricuspid valvoplasty in 4 and coronary artery bypass graft in 1. The extracorporeal circulation time was （72. 39 ± 30. 14） rain, blocking time was （47. 91±26. 39） min,mechanical ventilation time was （16.00±6.35） h, and ICU stay was （1.53±0.54） d. No severe complications after operation. Conclusion The incidence of cardiac myxoma is significantly higher in females than in males blood platelet count of some patients may be associated with embolism. Surgical treatment is safe and effective .