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目的总结原发性心脏肿瘤诊断和外科治疗的经验。方法回顾分析1980年1月至2005年1月间112例原发性心脏肿瘤患者的临床资料,其中心脏黏液瘤98例,心脏非黏液瘤性良性肿瘤3例,原发性心脏恶性肿瘤11例。心脏黏液瘤和非黏液瘤性良性肿瘤行肿瘤切除术;11例原发性心脏恶性肿瘤中,6例行肿瘤切除术,3例行姑息性手术,2例行单纯心包引流术。全组同期行二尖瓣置换术2例,二尖瓣成形术4例,三尖瓣成形术33例。结果术后早期生存108例,死亡4例,死亡率为3．6％。4例死亡患者中,2例黏液瘤患者分别因恶性心律失常和低心排于术后第2、7天死亡,1例原发性心脏恶性肿瘤患者术后第3天死于低心排,1例原发性心脏恶性肿瘤患者术后3周死于肝、肾功能衰竭。术后76例黏液瘤患者获得随访,随访时间3个月至17年,平均6．4年,未见复发。非黏液瘤性良性肿瘤3例随访结果与黏液瘤相似。11例原发性恶性肿瘤患者中,10例在术后1年内死亡;1例现术后11个月健在,尚无肿瘤复发。结论原发性心脏肿瘤患者早期准确诊断,积极手术治疗,其良性肿瘤患者几乎可以达到治愈的目;而恶性肿瘤患者预后很差,手术可减轻症状,并延长患者生存期。
Objective To summarize the experience of diagnosis and surgical treatment of primary cardiac tumors. Methods The clinical data of 112 patients with primary cardiac tumors from January 1980 to January 2005 were retrospectively analyzed. Among them, 98 were cardiac myxomas, 3 were non-myxomatous benign tumors, 11 were cardiac malignancies . Myxoma and non-myxomatous neoplasms were resected. In 11 patients with primary cardiac malignancy, tumor resection was performed in 6 cases, palliative surgery in 3 cases and simple pericardial drainage in 2 cases. In the same period, the whole group underwent mitral valve replacement in 2 cases, mitral valve repair in 4 cases and tricuspid valveoplasty in 33 cases. Results Postoperative early survival of 108 cases, 4 died, the mortality rate was 3.6%. Among the 4 death patients, 2 patients with myxoma died of malignant arrhythmia and low cardiac output on the 2nd and 7th day after operation. One patient with primary cardiac cancer died of low cardiac output on the third day after operation, One patient with primary cardiac cancer died of liver and kidney failure 3 weeks after operation. 76 cases of myxoma patients were followed up for 3 months to 17 years, an average of 6.4 years, no recurrence. Three cases of non-myxomatous benign tumor followed up with myxoma. Of the 11 patients with primary malignancy, 10 died within 1 year after surgery and 1 patient was alive 11 months after the operation, with no tumor recurrence. Conclusion Early diagnosis of patients with primary cardiac tumors, active surgical treatment, the benign tumor patients almost can achieve the purpose of cure; and malignant tumor patients with poor prognosis, surgery can reduce symptoms and prolong survival of patients.