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目的 :评价心脏恶性肿瘤的临床特点、手术所见、病理学类型、以及治疗情况 ;评价超声心动显像诊断心脏恶性肿瘤的准确性。方法 :1983年至 2 0 0 2年 12月在北京阜外心血管病医院手术和尸检及病理证实为心脏恶性肿瘤的患者 2 7例。 2 5例经手术和病理证实 ,2例尸检证实。 2 4例为心脏原发恶性肿瘤 ,3例为转移性心脏恶性肿瘤。全部患者均有术前经胸超声心动显像检查资料。男 17例 ,女 10例。年龄 1～ 72岁 ,平均 3 4岁。结果 :2 7例患者中 ,62 .95%肿瘤位于右心 (右心房占 3 3 .3 3 % ,右心室占 14 .81% ,浸润房室环及同时波及右房室占 14 .81%。) ;2 9 .63 %肿瘤位于左心 (左心房占 2 2 .2 2 % ,左心室占 7.41% ) ;7.41%位于心包。右心房肿瘤同时累及上腔静脉占 14 .81% ,累及下腔静脉占 14 .81% ,累及无名静脉占 3 .70 %。左心房肿瘤同时累及肺静脉占 7.41%。 2 4例 (88.89% )原发心脏恶性肿瘤中 ,间叶肉瘤 11例 (40 .74% ) ,血管肉瘤 5例 (18.52 % ) ,横纹肌肉瘤 2例 (7.41% ) ,纤维肉瘤 2例 (7.41% ) ,平滑肌肉瘤 1例 (3 .70 % ) ,非何杰金氏恶性淋巴瘤 1例 (3 .70 % ) ,心包间皮肉瘤 2例 (7.41% )。转移性心脏恶性肿瘤 3例 (11.11% ) ,其中转移性肝细胞癌 2例占 7.41% ,转移性上皮肉瘤 1例占 3 .70 %
OBJECTIVE: To evaluate the clinical features, surgical findings, pathological types, and treatment of cardiac malignancies. To evaluate the accuracy of echocardiography in the diagnosis of cardiac malignancies. METHODS: Twenty-seven patients with pathologically confirmed cardiac malignancy at the Fu Wai Hospital of Cardiovascular Surgery from January 1983 to December 2002 in Beijing were enrolled in this study. Twenty-five cases were confirmed by operation and pathology and confirmed by autopsy in two cases. 24 cases of primary cardiac cancer, 3 cases of metastatic cardiac cancer. All patients had preoperative transthoracic echocardiography examination data. 17 males and 10 females. Aged 1 to 72 years, an average of 34 years old. Results: Of the 27 patients, 62.95% of the tumors were located in the right heart (33.33% in the right atrium, 14.81% in the right ventricle, 14.81% in the infrarenal atrioventricular loop and right atrium) ); 29.6% of the tumors were located in the left heart (left atrium accounted for 22.22%, left ventricular accounted for 7.41%); 7.41% in the pericardium. Right atrial tumor involving the superior vena cava accounted for 14.81%, involving the inferior vena cava accounted for 14.81%, involving anonymous vein accounted for 3.70%. Left atrial tumor involving pulmonary vein accounted for 7.41%. There were 11 cases (40.74%) of mesenchymal sarcoma, 5 cases of angiosarcoma (18.52%), 2 cases of rhabdomyosarcoma (7.41%) and 2 cases of fibrosarcoma (7.41%) in 24 primary cardiac malignancies (88.89% ), 1 case of leiomyosarcoma (3.70%), 1 case of non-Hodgkin’s lymphoma (3.70%) and 2 cases of pericardial mesangarcoma (7.41%). 3 cases (11.11%) of metastatic cardiac malignancies, of which 2 cases of metastatic hepatocellular carcinoma accounted for 7.41%, 1 case of metastatic epithelial sarcoma accounted for 3.70%