继发性心脏及心包肿瘤38例临床分析
心脏,肿瘤,,心脏,肿瘤；心包,肿瘤；恶性肿瘤,1对象与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨继发性心脏及心包肿瘤的诊断和治疗方法。方法 回顾性分析近5年来我院共收治的继发性心脏及心包肿瘤38 例患者的临床资料，并结合文献复习。经ECG、胸部X线、超声心动图(UCG)、CT，再经活检或穿刺抽液做病理学检查，确定诊断。继发性心脏及心包肿瘤38例，其中肺癌25例，乳腺癌5例，食管癌2例，肝癌2例，胰腺癌2例，胆管癌1例,左足趾滑膜肉瘤1例。对确诊的不同患者采用不同的治疗方法，其中16例手术治疗，同时全身化疗和(或)放疗，9例全身化疗和(或)放疗，辅以局部化疗，13例保守治疗，10例心包引流、局部化疗。结果 16例手术切除治疗，同时全身化疗和(或)放疗，9例全身化疗和(或)放疗，辅以局部化疗，最长1例存活达9年，余存活15天~1年；13例保守治疗，存活7天~6个月。结论 UCG对继发性心脏及心包肿瘤诊断价值较大，确诊仍需病理学检查。继发性心脏及心包肿瘤,多数原发部位癌在先，至晚期广泛转移，少数以心脏及心包转移为首发症状，虽经手术治疗、化疗和(或)放疗，但预后差。伴心脏压塞者，给予心包穿刺、引流，局部化疗,可减轻症状，但不改善预后。【关键词】 心脏,肿瘤；心包,肿瘤；恶性肿瘤
Clinical analysis of secondary tumors of heart and pericardium
FENG Mei-yun，WU Guo-xia，SUN Gang,et al.Department of Cardiology,The Second Affiliated Hospital of Baotou Medical College,Baotou 014030,China
【Abstract】 Objective To study the diagnosis and therapy of secondary tumors of heart and pericardium.Methods The author analyzed retrospectively the clinical data of 38 patients with secondary malignant cardiac and pericardium tumor admitted to our hospital during 2001~2005.The electrocardiogram,the plain Xray,echocardiography(UCG),CT were utilized as diagnostic modalities and pathological classification of the tumors was made by exfoliative cytologic and histological examination.16 patients were treated by operation plus total body chemotherapy and(or) radiotherapy;9 patients were treated with total body chemotherapy and(or) radiotherapy;10patients with pericardium tamponade were made by pericardial sacdrainage local chemotherapy in pericardial cavity.13 patients who were elder and cachexi,were conservatively treated.Results 38patients with secondary malignant cardiac and pericardium tumor including 25 patients with lung cancer,5 patients with mastocarcinoma,2 patients with esophageal carcinoma,2 patients with liver carcinoma,2 patients with pancreatic carcinoma,1 patients with bile duct carcinoma,1 patients with synovio sarcoma of left toe.Only one of 16 patients was living for 9 years,others survived ranging from 15 days to 1 years.13 patients underwent conservative treatment survived ranging from 1 week to half a year.Conclusion UCG are helpful and reliable for the diagnosis of secondary malignant tumors of heart.Accurate diagnosis is only made by histological examination.Most of patients whose primary tumor were discovered ahead.In minority of patients pericardium tamponade were first symptem.Bad prognsis is dispite of all kinds of therapy.Patients accompanied with pericardium tamponade should be treated by pericardial sacdrainage,local chemotherapy in pericardial cavity which could improve symptoms. ......
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