累及心脏的子宫静脉平滑肌瘤病诊治分析

Analysis of the diagnosis and treatment of uterine venous smooth muscle tumour involving the heart

目的:分析累及心脏的子宫静脉平滑肌瘤(ICL)的病理学表现、诊断方式及治疗方法。方法:回顾分析深圳市妇幼保健院于2007年1月至2016年12月,进行手术治疗的32例ICL患者的超声、MRI、CT等影像学检查及病理学检查,以明确ICL诊断结果。19例采用一期手术治疗,13例采用分期手术治疗。比较两种方式的并发症状况、伤口感染情况、术后复发率。结果:经影像学检查发现患者盆腔处有囊实性病变,腹腔和肾脏有液体积存、下腔静脉、右心腔均可见静脉肌瘤。经病理学检验证实为ICL。分期手术治疗的ICL患者术后复发率及术后感染率明显低于一期手术治疗的患者(P<0.05)。术后并发症发生率两种方法无明显差异(P>0.05)。结论:ICL首选治疗方式为手术,其中分期手术治疗的效果较一期手术治疗效果更优。

Objective: To analyze the pathology, diagnosis and treatment of uterine vein leiomyoma involving the heart. Methods: Retrospective analysis of 32 cases of uterine smooth muscle tumor involving the heart and who underwent the surgical treatment in maternal and child health care hospital of Shenzhen City from January 2007 to December 2016 and underwent heart involvement venous ultrasound, MRI, CT etc. learn check and pathology, to clear the heart of the uterine vein leiomyoma diagnosis result. 19 cases were treated with one stage operation and 13 cases were treated with staged operation.Then,the complications, wound infection,recurrence rate after operation of two method were compared. Results: The imaging examination can be found to have cystic lesions in patients with pelvic, abdominal and kidney liquid accumulation and inferior vena cava and right ventricular cavity were visible vein leiomyoma. It was confirmed by pathological examination as leiomyoma of uterine vein.The recurrence rate and infection rate after operation of patient of uterine venous leiomyoma involving the heart in the staged surgical treatment were significantly less than one stage surgical treatment(P<0.05). There was no significant difference in the incidence of postoperative complications between the two method(P>0.05). Conclusions: The first choice of treatment for uterine vein leiomyoma involving the heart is surgery, and the effect of staging surgery is better than that of one-stage operation..