中国近12年静脉内平滑肌瘤病病例分析(附5例报道)  

Analysis of Intravenous Leiomyomatosis Cases in China in the Past 12 Years(Report of 5 Cases Appended)

作　　者：邱阳 刘芸[1] QIU Yang;LIU Yun(Department of Obstetrics and Gynecology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院妇产科,北京100050

出　　处：《医学综述》2020年第13期2698-2704,共7页Medical Recapitulate

摘　　要：目的总结分析中国近12年静脉内平滑肌瘤病(IVL)病例的发病特征及临床特点,并结合北京友谊医院收治病例,复习相关文献。方法检索中文数据库中国知网和万方数据库,获取2007年1月至2018年12月有关IVL的病例报道资料并进行统计分析。结果共获取病例694例,均为女性,年龄23~76岁,平均年龄43.6岁;经产妇占94.3%(181/192);73.3%(258/352)有子宫肌瘤病史;无明显症状者占36.8%(222/603),其余表现为异常子宫出血、腹痛腹胀、胸闷、下肢水肿等非特异性症状。57.0%(319/560)病例肿瘤仅局限于子宫及周围,26.3%(147/560)累及心脏;80.9%(38/47)瘤栓与血管壁无任何粘连;静脉内瘤栓长度3.5~64 cm,直径0.2~6 cm;46.5%(222/477)行子宫+双侧附件切除术。结论IVL罕见,临床表现缺乏特异性,早期诊断困难,误诊率高,切除子宫及双侧附件并完全切除脉管内肿瘤可获得良好预后。Objective To analyze and summarize the characteristics of disease and clinical features of intravenous leiomyomatosis(IVL)cases reported in China in the past 12 years and review the related literature combined with the cases treated in Beijing Friendship Hospital.Methods Case reports on IVL published between Jan.2007 and Sep.2018 were collected from China National Knowledge Infrastructure(CNKI)and Wanfang Database,and the clinical data were statistically analyzed.Results A total of 694 cases were reported,all female,aged ranging from 23 to 76 years with a mean age of 43.6 years.Multipara accounted for 94.3%(181/192)of the cases.73.3%(258/352)had a history of uterine myoma.36.8%(222/603)had no obvious symptoms,and others had nonspecific symptoms including abnormal uterine bleeding,abdominal discomfort,chest tension,lower extremity edema.57.0%(319/560)of the tumors were confined to the uterus and its surroundings,and 26.3%(147/560)extended to the heart.In these cases,80.9%(38/47)of the tumor mass were not adhesive with the venous wall.The length of the tumor thrombus mass ranged 3.5-64 cm with a diameter of 0.2-6 cm.46.5%(222/477)of the cases had hysterectomy and bilateral-adnexectomy.Conclusion Due to low prevalence and nonspecific clinical presentations,early diagnosis of IVL is difficult with a high misdiagnosis rate.Good prognosis can be achieved by removing the uterus and bilateral appendages and completely removing the tumors in the vessels.

关 键 词：静脉内平滑肌瘤病 子宫肌瘤 病例分析 

分 类 号：R737.3[医药卫生—肿瘤]