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目的评价婴幼儿及儿童心脏肿瘤的临床特点、手术所见、病理学类型、以及治疗情况;评价超声心动图诊断婴幼儿及儿童心脏肿瘤的准确性。方法1983年12月至2003年12月在北京阜外心血管病医院手术和病理证实为心脏肿瘤的患者19例,男8例,女11例;年龄5个月~14岁,平均(7±5)岁。结果19例患者中,良性肿瘤17例(89.5%),其中黏液瘤10例(52.6%),横纹肌瘤4例(21.1%),纤维瘤2例(10.5%),脂肪瘤1例(5.3%);恶性肿瘤2例(10.5%),其中横纹肌肉瘤和转移性上皮肉瘤各1例。19例肿瘤中,11例位于左心(57·9%),7例位于右心(36.8%),1例位于双心室(5.3%)。术前超声10例诊断黏液瘤和1例怀疑横纹肌瘤与术后病理结果一致(11/19,57.9%),其余8例因超声缺乏经验,诊断为心脏占位病变性质待定或黏液瘤可能性大(8/19,42.1%)。结论婴幼儿和儿童心脏原发肿瘤多为黏液瘤,其次为横纹肌瘤,纤维瘤和脂肪瘤。黏液瘤多见于较大儿童,横纹肌瘤多见于婴幼儿,可呈多发性生长。当临床表现严重并难以控制时应选择手术。
Objective To evaluate the clinical features, surgical findings, pathological types, and treatment of cardiac tumors in infants and children. To evaluate the accuracy of echocardiography in the diagnosis of heart tumors in infants and children. Methods Nineteen males and 8 females, 11 females, aged from 5 months to 14 years old, with an average of (7 ± 2) years old, were enrolled in the study. They were confirmed as cardiomas by surgery and pathology in Fu Wai Hospital of Cardiovascular Diseases from December 1983 to December 2003, 5) years old. Results Of the 19 patients, 17 (89.5%) had benign tumors, including 10 myxomas (52.6%), 4 rhabdomyosarcomas (21.1%), 2 fibroids (10.5%), 1 lipoma (5.3% ); 2 cases of malignant tumors (10.5%), including rhabdomyosarcoma and metastatic epithelial sarcoma in 1 case. Of the 19 tumors, 11 were located in the left heart (57.9%), 7 in the right heart (36.8%) and 1 in the biventricular (5.3%). Preoperative ultrasound in 10 cases of diagnosis of myxoma and 1 case of rhabdomyosarcoma suspected with postoperative pathological findings (11/19, 57.9%), the remaining 8 cases due to lack of experience of ultrasound diagnosis of heart lesions lesions to be determined or the possibility of myxoma Large (8 / 19,42.1%). Conclusions Most of the primary cardiac tumors in infants and children are myxomas, followed by rhabdomyoma, fibroids and lipomas. Myxoma more common in larger children, rhabdomyosarcoma more common in infants and young children, showed multiple growth. When the clinical manifestations of severe and difficult to control should choose surgery.