8例原发性心室肿瘤外科治疗的中远期效果

Clinical Feature and Mid-and Long-term Results of Surgical Treatment of 8 Patients with Primary Ventricular Tumor

目的:介绍原发性心室肿瘤的临床特点和外科治疗体会。方法:自1981年10月至2001年7月外科治疗原发性心室肿瘤8例,男6例,女2例,年龄3～52岁。其中左心室多发性粘液瘤2例,左心室横纹肌瘤、纤维瘤和恶性神经鞘瘤各1例,右心室粘液瘤和恶性神经鞘瘤各1例,室间隔纤维瘤1例。胸部正中切口、中度低温体外循环下手术7例,左前外切口、非体外循环下手术1例。肿瘤摘除或完全切除7例,大部切除1例。结果:麻醉后心跳骤停1例,术后昏迷10天,经综合治疗痊愈。术后因消化道大出血死亡1例,存活7例,随访1～21年,肿瘤完全切除的6例无复发和转移,大部切除的1例残留轻度心脏杂音,肿瘤无进一步生长,所有患者均无临床症状,心功能Ⅰ级。结论:原发性心室肿瘤的组织学类型呈现多样性,外科治疗的中远期效果良好。

Objec ti ve:To summarize the clinical feature and surgical treatment of primary ventric ular tumor.Methods:Eight patients with primary ventricular tumor,aged3to5 2years,underwent surgical treatment.There were6males and2females.The path ological diagnoses were multiple left ventricular myxomas in2cases;left ventri cular rhabdomyoma,fibroma and malignant neurolemmoma in1respectively;right ventricular myxomas and malignant neurolemmoma in1re-spectively;ventricul ar septal fibroma in1.The operations were performed through median ster-noto my with moderate hypothermic cardiopulmonary bypass in7cases,via left anterol ateral thora-cotomy without extracorporeal circulation in1.Tumors were comp letely removed in7cases,par-tially resected in1.Results:There was no opera tive death.Cardiac arrest after anaesthetization occurred in1case with postope rative coma of10days,1case died of massive gastric hemor-rhage postoperati vely.Seven cases survived,1had mild heart murmur without tumor progression ,no patients had symptoms,recurrence and metastasis during a follow-up of1to 21years.Con-clusions:The primary ventricular tumor showed multiple histolog ical feature.Mid-and long-term results of surgical treatment for primary ven tricular tumor appear to be satisfactory.