摘要
目的探讨术前超声心动图综合评价黏液瘤的形态、大小、发生部位以及肺动脉压的价值。方法采集132例(男47例,女85例)心脏黏液瘤患者的术前超声评价、临床症状、术中所见及预后等临床资料,进行回顾性分析。结果①临床症状:心慌、气短84例(63.64%),栓塞12例(9.09%),晕厥11例(8.33%),发热5例(3.79%),贫血2例(1.52%),胸腔积液2例(1.52%),心房颤动9例(6.82%),肾炎3例(2.27%)。②术中所见:左心房黏液瘤121例(91.67%),右心房黏液瘤11例(8.33%)。起源于房间隔左心房面81例(61.36%),左心房后壁19例(14.39%),左心房顶部16例(12.12%),靠近二尖瓣环5例(3.79%);起源于房间隔右心房面5例(3.79%),下腔静脉开口附近5例(3.79%),冠状静脉窦内1例(0.76%)。本组中2例复发。③根据是否有肺动脉压力增高将121例左心房黏液瘤患者分为两组,两组间瘤体大小差异有统计学意义(P<0.05);起源于左心房顶部者瘤蒂明显长(P<0.05),伴有肺动脉压力增高的例数所占比重明显低于其他黏液瘤(P<0.05),该黏液瘤质量也明显大于其他黏液瘤(P<0.01)。结论黏液瘤形态、大小、发生部位与肺动脉压有一定关系,超声心动图应作为术前诊断的重要手段。
Objective evaluate cardiac myxomas on the original position,clinical symptoms,prognosis and the relation to the pressure of pulmonary artery with echocardiography preoperatively. Methods The pre-operative echocardiogram,clinlcal symptoms and findings in operation of 132 patients （47 male and 85 female） with cardiac myxomas were analyzed retrospectively. Results ①Clinical symptoms：Dyspnea happened in 84 patients （63.64%）,embolism in 12 （9.09%）,apopsychia in 11 （8.33%）,fever in 5 （3.79%）,hemophthisis in 2 （1.52%）,pleural effusion in 2 （1.52%）,atrial fibrillation in 9 （6.82%）and nephritis in 3 （2.27%）. ②Anatomical findings：Left atrial myxomas were found in 121 patients （91.67%）,while right atrial myxomas in 11 patients （8.33%）. Among left atrial myxomas,81 generated in atrial septum （61.36%）,19 in the posterior wall of left atrium （14.39%）,16 in the top of left atrium （12.12%）,5 nearby mitral annulus （3.79%）. Among right atrial myxomas,5 generated in atrial septum （3.79%）,5 nearby inferior vena cave （3.79%）,1 in vena coronaria sinus （0.76%）. The tumors recurred after treatment in 2 patients. ③One hundred and twenty-one patients of left atrial myxomas were divided into two groups according to pulmonary arterial pressure. The sizes of myxomas body were significant difference in two groups （P0.05）. The myxomas in the top of left atrium caused less pulmonary hypertension （P0.05）,had longer pedicel （P0.05） and more weight （P0.01）. Conclusion Pulmonary artery pressure has some relationship with the shape,size and position of the cardiac myxomas. Echocardiography should be considered as an important method of preoperative evaluation of cardiac myxomas.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第10期1889-1891,共3页
Chinese Journal of Medical Imaging Technology
