静脉内平滑肌瘤病临床特点及诊断  

Clinical manifestation and diagnosis of intravenous leiomyomatosis

作　　者：薛超[1] 赵映[1] 王炜琦 谷孝艳[1] 龚静[2] 罗天戈[3] 何怡华[1] XUE Chao;ZHAO Ying;WANG Weiqi;GU Xiaoyan;GONG Jing;LUO Tiange;HE Yihua(Department of Ultrasonic,Beijing Anzhen Hospital,Capital Medical Univerity,Beijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所胎儿心脏病母胎医学研究北京市重点实验室超声二部,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所胎儿心脏病母胎医学研究北京市重点实验室妇产科,100029 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所胎儿心脏病母胎医学研究北京市重点实验室心外科,100029 [4]新疆维吾尔自治区乌鲁木齐市玛丽妇产医院超声科

出　　处：《心肺血管病杂志》2021年第1期74-77,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结静脉内平滑肌瘤病(IVL)的临床特征及治疗预后。方法:回顾性分析北京安贞医院2008年12月至2019年12月,经手术后病理证实诊断为静脉内平滑肌瘤病23例,总结临床病例资料,并随访观察临床治疗结局。结果:23例静脉内平滑肌瘤病的患者均为女性,年龄41~60岁,平均年龄(47.6±4.89)岁,中位年龄47岁。3例(13.0%)位于双附件区及生殖静脉内,行双子宫及附件切除术;20例(87.0%)位于下腔静脉内,其中4例(17.4%)局限于下腔静脉内,行下腔静脉内占位切除术;16例(69.6%)延伸至心脏,其中3例分两次手术,先切除心脏内占位,后再次手术切除下腔静脉内占位,13例一次手术取出心脏内及下腔静脉内的静脉内平滑肌瘤。随访均无复发。结论:中老年女性,尤其有子宫肌瘤/子宫及附件切除病史的患者,超声发现IVC和/或RA内中低回声柔软光滑占位的患者,应考虑为IVL可能。IVL主要为手术治疗,规律术后复查,预防复发。Objective:The objective of this study was to summarize the clinical features and prognosis of intravenous leiomyomatosis(IVL).Methods:We used retrospectively analyzed 23 cases of intravenous leiomyomatosis diagnosed in Beijing Anzhen Hospital from December 2008 to December 2019.The clinical data of the patients were summarized and the follow up result were observed.Results:All the 23 patients were female,median 47 years.Three cases(13.0%)were located in the double adnexal area and genitourinary vein,and underwent double hysterectomy and adnexectomy;20 cases(87.0%)were located in the inferior vena cava(IVC),4 cases(17.4%)were confined to the IVC;16 cases(69.6%)were extended to the heart,3 cases received two times operations that the lesion in the heart was removed for the first time and then the rest of IVL was resected.No recurrence was found during follow-up.Conclusions:Middle-aged and elderly female patients with the history of uterine fibroids,hysterectomy and/or adnexectomy should be considered as IVL when ultrasound result show the moderate or low echogenicity,soft and smooth space occupying lesions in IVC and/or RA.The treatment of IVL mainly includes surgical treatment,regular follow up and prevention of recurrence.

关 键 词：静脉内平滑肌瘤病 下腔静脉 心脏超声 

分 类 号：R54[医药卫生—心血管疾病]