摘要
目的回顾和总结小儿原发性心脏肿瘤的治疗经验。方法7例患儿，男3例，女4例；年龄1个月～10岁（〈1岁4例）；体重3．5～24kg（〈10kg5例）。右室横纹肌瘤1例，左室纤维瘤1例，左房粘液瘤2例。右房粘液瘤1例，有房血管瘤2例。右室横纹肌瘤经右室切口切除。纤维瘤累及整个左室游离壁而无法切除。左房粘液瘤和右房粘液瘤均经右房切口完整切除。血管瘤经右房切口径路，1例整个切除，另1例因肿瘤下缘累及右冠状动脉，作大部分切除。结果术后入重症监护室，4～6h后撤离呼吸机。左室纤维瘤因未能手术切除而临床症状不能解除，其余患儿循环功能稳定，无明显心包积液，心律失常和动脉栓塞并发症。出院时心脏超声检查，右室横纹肌瘤近心尖处仍有直径1cm的残留肿块，但不影响心功能。所有患儿房室瓣和大动脉瓣口的血流速度恢复正常。5例患儿随访2～3年，心脏血流动力学稳定，肿瘤无复发或远处转移，横纹肌瘤残留已不明显。结论小儿原发性心脏肿瘤应根据肿瘤的不同性质，制定不同的手术原则，完整切除不是手术的唯一目的，其前提是不能破坏心功能。
Objective To review and summarize the experience of surgical treatment for primary cardiac tumors in children. Methods There were 7 patients （male 3 and female 4, aged from 1 month to 10 years） with primary cardiac tumors. The body weight of these patients ranged from 3.5 to 24 kg. Pathological examination found rhabdomyoma in 1, fibroma in 1, myxoma in 3 and hemangioma in 2. Total tumor removal was achieved in 1 patient with rhabdomyoma, 3 with myxoma and 1 with hemanigoma. The other two tumors were partly resected. Results They were all monitored in CICU after operation. Except 1 patient with the fibroma, the other patients＇hemodynamics was stable. There was no pericardium effusion, arrhythmia or thrombo embolism. 2D-Echo showed rhabdomyoma was residual at the right ventricular apex but didn＇t influence heart function. There was no obstruction of the cardiac inlet or outflow tract. Five patients underwent follow-up for 2-3 years. There was no tumor recurrence or distant metastasis even in these patients with incomplete resection. Conclusions Total resection of the tumor is not the only therapeutic aim in children with cardiac tumors. The restoration of the heart function is the prior consideration in these patients.
出处
《中华小儿外科杂志》
CSCD
北大核心
2006年第1期13-15,共3页
Chinese Journal of Pediatric Surgery
关键词
心脏肿瘤
心脏外科手术
Heart neoplasms
Cardiac surgical procedures
