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目的:提高对原发性心脏肿瘤的外科治疗技术。方法:对1980年8月～1999年6月治疗的24例原发性心脏肿瘤病例的临床资料进行分析。全组男8例,女16例,年龄6～69岁(403±158岁)。其中20例为粘液瘤(左房17例,右房3例),肉瘤2例(平滑肌肉瘤1例,纤维肉瘤1例),血管肉瘤1例,恶性间皮瘤1例。21例于中低温体外循环下心内直视手术,其中8例未行升主动脉阻断。结果:1例于术前死亡。1例围术期死于低心排,手术病死率43%。随访2月～8年。良性肿瘤无远期死亡和复发,3例恶性肿瘤分别于术后6月内死亡。结论:一旦诊断确立应尽早手术治疗。右房经房间隔切口是最适入路。为改善预后、减少复发,肿瘤蒂应作全层、广泛切除。对恶性心脏肿瘤手术目的主要是改善血流动力学
Objective: To improve the surgical treatment of primary cardiac tumors. Methods: The clinical data of 24 cases of primary cardiac tumors treated from August 1980 to June 1999 were analyzed. The whole group consisted of 8 males and 16 females, aged 6 to 69 years (403±158 years). Among them, 20 cases were myxoma (17 cases of left atrium and 3 cases of right atrium), 2 cases of sarcoma (1 case of leiomyosarcoma, 1 case of fibrosarcoma), 1 case of angiosarcoma, and 1 case of malignant mesothelioma. Twenty-one patients underwent open heart surgery under moderate hypothermic cardiopulmonary bypass, and 8 of them had no ascending aorta blockade. Results: One patient died before surgery. One patient died of low cardiac output during the perioperative period, and the surgical mortality rate was 43%. Follow-up from February to 8 years. There were no long-term deaths and recurrences of benign tumors, and 3 malignant tumors died within 6 months after surgery. Conclusion: Once the diagnosis is established, surgical treatment should be performed as soon as possible. The right atrium transseptal incision is the most suitable approach. In order to improve the prognosis and reduce the recurrence, the tumor pedicle should be full-thickness and extensive resection. The main purpose of surgery for malignant heart tumors is to improve hemodynamics