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。
Objective:To analyze the clinical and pathological features of uterine intra-venous leiomyomatosis ( IVL) and to evaluate its diagnostic and therapeutic strategies. Meth-ods:Sixty-four patients of IVL were enrolled in this retrospective analysis during the period of July 2007 to June 2013 in Obstetrics and Gynecology Hospital of Fudan University. Results:Symptoms of IVL were usually nonspecific or similar to those usual counterparts. Most patients experienced hypermenorrhea,abdominal pain or distension,pelvic mass,and secondary anemia. Only 3 cases were diagnosed preoperatively by ultrasound. Majority cases could be diagnosed during surgery by frozen section. Neoplasm occurred in the corpus (73. 4%),broad ligament (18. 8%) and uterus isthmus (7. 8%). Myomectomy (4. 7%),hysterectomy (39. 1%) and hysterectomy with bilateral salpingo-oophorectomy (56. 2%) were performed for treatment. Fol-low-up information was available for 50 patients, with a median follow-up duration of 28 months. Only one case recurred after myomectomy and then hysterectomy was launched,without sign of relapse until the last follow-up. Conclusions:Diagnosis of IVL is difficult. Surgery is the main treatment method. It is important to adequately examine the leiomyoma and its surrounding intraoperatively. A satisfactory therapeutic effect can be achieved by selecting the appropriate extent of surgery. Long-term follow-up of IVL patients after operation is important.
出处
《现代妇产科进展》
CSCD
北大核心
2015年第4期262-265,共4页
Progress in Obstetrics and Gynecology