子宫静脉内平滑肌瘤病64例临床病理分析  

Clinicopathological characteristics analysis of 64 cases of uterine intravenous leiomyomatosis

作　　者：范灵玲[1] 朱瑾[1] 陶祥[2] 徐丛剑[1] 

机构地区：[1]复旦大学附属妇产科医院妇产科,上海200011 [2]复旦大学附属妇产科医院病理科,上海200011

出　　处：《现代妇产科进展》2015年第4期262-265,共4页Progress in Obstetrics and Gynecology

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.

关 键 词：静脉内平滑肌瘤病 子宫肌瘤 子宫 临床-病理分析 

分 类 号：R737.33[医药卫生—肿瘤]