婴幼儿心脏肿瘤的治疗与预后

Treatments and follow-ups for cardiac tumors in pediatric patients

目的探讨婴幼儿心脏肿瘤的诊断、治疗经验以及随访情况。方法回顾性分析大连医科大学附属大连市儿童医院心脏中心2013年8月至2019年11月收治的9例婴幼儿心脏肿瘤患儿的住院资料及随访结果。其中,男7例,女2例;年龄(6.33±8.06)个月,范围在1 d至27个月;入院体重(6.57±2.89)kg,范围在3.7~12.5 kg;均通过经胸超声心动图和心脏增强CT等检查明确肿瘤情况。结果9例患儿中,5例选择手术治疗,4例未手术。手术患儿均在体外循环辅助下切除肿瘤,其中1例心脏肿瘤行自体心脏移植手术切除。术后病理检查报告横纹肌瘤4例,纤维瘤1例。未手术患儿中,1例为肝母细胞瘤转移瘤,放弃治疗后自行出院并于3个月后失访;1例为心包腔占位肿瘤;2例为合并结节性硬化症。8例患儿出院后获随访4~76个月,行手术治疗5例患儿无肿瘤复发,心功能良好;余3例未手术患儿心脏超声检查示心脏肿瘤缩小。结论婴幼儿心脏肿瘤以原发的良性肿瘤为主,根据肿瘤情况选择个体化治疗方案,对于肿瘤巨大或位置特殊的患儿可选择自体心脏移植术切除肿瘤,术后患儿预后良好。

Objective To summarize the experiences of diagnosing,treating and follow-ups of cardiac tumors in children.Methods From August 2013 to November 2019,retrospective analysis was performed for 9 children with cardiac tumors.There were 7 boys and 2 girls with an age range of 1 day to 27 months and a body weight of(6.57±2.89)(3.7-12.5)kg.The diagnosis was confirmed by echocardiography and computed tomography.Results Surgery(n=5)and non-surgery(n=4)were performed.Surgical procedure was central thoracic resection by cardiopulmonary bypass.One child underwent cardiac autotransplantation for tumor removal.Histologic examination revealed rhabdomyoma(n=4)and fibroma(n=1).The causes of non-surgical children included secondary cardiac tumor(n=1),external cardiac tumor(n=1)and tuberous sclerosis(n=2).During a follow-up period of(4-76)months post-discharge,no tumor recurrence was found in surgical children.Echocardiography revealed that size of cardiac tumor diminished in 3 non-surgical cases.Conclusion Primary benign cardiac tumors occur frequently in children.Surgery is efficacious.And cardiac autotransplantation is reserved for removing large tumors in children.