子宫源性静脉内平滑肌瘤病7例临床分析

发布时间：2018-05-06 13:48

本文选题：子宫源性静脉内平滑肌瘤病 + CT血管成像　；参考：《中国实用外科杂志》2015年12期

【摘要】：目的总结子宫源性静脉内平滑肌瘤病(IVL)的诊断及治疗方法。方法回顾性分析中国医科大学附属第一医院2004年9月至2015年9月收治的7例IVL的临床资料。结果 7例病人中5例行手术治疗,2例行保守治疗。手术病人术后病理学检查均证实为子宫源性平滑肌瘤病。术中见5例病人均累及子宫静脉、髂静脉、卵巢静脉及下腔静脉,累及右心房4例,累及右心室及肺动脉1例。5例病人IVL均来源于子宫肿瘤。随访结果:7例病人均获随访。1例病人术后2个月因呼吸、循环功能衰竭死亡,2例未手术病人分别于出院后3年及4年死亡。1例低级别子宫内膜间质肉瘤病人术后1年复发。结论 IVL是一种少见但高危的疾病,手术复杂、困难,应在临床诊断上予以足够的重视,防止漏诊及误诊。术前应详细制定手术方案。
[Abstract]:Objective to summarize the diagnosis and treatment of uterine venous leiomyomatosis (IVL). Methods the clinical data of 7 cases of IVL admitted from September 2004 to September 2015 in the first affiliated Hospital of China Medical University were retrospectively analyzed. Results among 7 cases, 5 cases were treated by operation and 2 cases were treated conservatively. Postoperative pathological examination of all patients confirmed uterine leiomyomatosis. Intraoperative involvement of uterine vein, iliac vein, ovarian vein and inferior vena cava, right atrium in 4 cases, right ventricle and pulmonary artery in 1 case, IVL originated from uterine tumor in 5 cases. Results all 7 cases were followed up. 1 cases died of respiratory and circulatory failure in 2 months after operation. 2 cases died of non-operation in 3 years and 4 years after discharge. 1 case of low grade endometrial stromal sarcoma recurred 1 year after discharge. Conclusion IVL is a rare but high risk disease. The operation is complicated and difficult. We should pay enough attention to clinical diagnosis to prevent missed diagnosis and misdiagnosis. The operative plan should be worked out before operation.
【作者单位】：中国医科大学附属第一医院血管外科;
【分类号】：R737.33

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