子宫静脉内平滑肌瘤病64例临床病理分析

发布时间：2018-08-21 07:35

【摘要】：目的:研究子宫静脉内平滑肌瘤病的临床病理特征,探讨该疾病的诊断和治疗策略。方法:回顾分析2007年7月至2013年6月复旦大学附属妇产科医院收治的64例静脉内平滑肌瘤病患者的临床病理资料。结果:子宫静脉内平滑肌瘤病的临床表现缺乏特异性,与普通子宫平滑肌瘤类似,主要为月经量增多、腹痛腹胀、盆腔肿块及继发贫血。仅有3例在术前彩色多普勒超声检查中被疑诊为子宫静脉内平滑肌瘤病。术中冰冻病理多能提示静脉内平滑肌瘤病,肌瘤主要位于子宫体(73.4%)、阔韧带(18.8%)及子宫峡部(7.8%)。手术方式包括子宫肌瘤剥出术(4.7%)、全子宫切除术(39.1%)及全子宫+双附件切除术(56.2%)。术后获访的50例患者的随访中位时间为28个月,仅有1例在子宫肌瘤剥出术后复发,行全子宫切除术后随访至今未复发。结论:子宫静脉内平滑肌瘤病术前诊断困难,手术切除是主要治疗方式。术中仔细探查,选择适当的手术方式可获得满意的治疗效果,术后需密切随访。
[Abstract]:Objective: to study the clinicopathological features of intrauterine leiomyomatosis and to explore the diagnosis and treatment of the disease. Methods: the clinicopathological data of 64 patients with venous leiomyomatosis admitted to the Department of Obstetrics and Gynecology of Fudan University from July 2007 to June 2013 were retrospectively analyzed. Results: the clinical manifestations of leiomyomatosis in uterine vein were lack of specificity and were similar to those of normal uterine leiomyoma. The main clinical manifestations were increased menstrual volume abdominal pain abdominal distension pelvic mass and secondary anemia. Only 3 cases were suspected of intrauterine leiomyomatosis by color Doppler ultrasonography before operation. The intraoperative frozen pathology showed that the leiomyomatosis of vein was mainly located in uterine body (73.4%), broad ligament (18.8%) and uterine isthmus (7.8%). The operative methods included myomectomy (4.7%), total hysterectomy (39.1%) and total double appendage hysterectomy (56.2%). The median follow-up time of 50 cases was 28 months. Only 1 case recurred after myomectomy, and no recurrence occurred after hysterectomy. Conclusion: preoperative diagnosis of intrauterine leiomyomatosis is difficult and surgical resection is the main treatment. Careful exploration during operation and selection of appropriate surgical methods can obtain satisfactory therapeutic effect and should be followed up closely after operation.
【作者单位】：复旦大学附属妇产科医院妇产科;复旦大学附属妇产科医院病理科;
【分类号】：R737.33

【参考文献】