静脉内平滑肌瘤病累及右心腔2例并文献复习  

Intravenous leiomyomatosis involving right heart cavity:a report of two cases and literature review

作　　者：卞雨洁 任贺 张云山 解翔[3] BIAN Yujie;REN He;ZHANG Yunshan;XIE Xiang(Department of Outpatient,Yangfang Branch,Jingnan Medical District,Chinese People’s Liberation Army General Hospital,Beijing 100039,China;The Sixth Medical Center of People’s Liberation Army General Hospital,Beijing 100048,China;Department of Interventional ultrasound,the Second Hospital of Anhui Medical University,Anhui Province,Hefei 230601,China)

机构地区：[1]中国人民解放军总医院京南医疗区羊坊店门诊部,北京100039 [2]中国人民解放军总医院第六医学中心,北京100048 [3]安徽医科大学第二附属医院介入超声科,安徽合肥230601

出　　处：《中国医药导报》2024年第17期192-194,共3页China Medical Herald

摘　　要：静脉内平滑肌瘤病是一种罕见变异的特殊类型的子宫平滑肌瘤,源自静脉血管平滑肌细胞或子宫肌细胞,临床发病率较低,属于良性增殖性病变,但有恶性肿瘤生长方式,易沿人体静脉系统生长,部分可累及心脏,造成不同程度的梗阻,严重者导致患者猝死,故早期诊断并准确评估可提高生存率。患者临床表现为呼吸困难、胸闷、胸痛、双侧下肢水肿、腹胀及盆腔包块等。主要诊断包括定位诊断、定性诊断,影像学检查用于定位诊断,病理学检查用于定性诊断。干预方式和结局是尽早手术、尽早恢复正常血流动力学。彩色多普勒超声是临床推广范围较广的超声检查措施,具有无创、安全、准确率高等优点,患者及家属均接受良好。若出现呼吸、循环系统症状尤其既往有子宫肌瘤病史的患者,应高度警惕子宫静脉内平滑肌瘤病,值得临床诊断中进一步普及。Intravenous leiomyomatosis is a special type of uterine leiomyoma with rare variation.It originates from venous vascular smooth muscle cells or uterine muscle cells.Its clinical incidence rate is low,and it belongs to benign proliferative disease.However,it has a malignant tumor growth mode,which is easy to grow along human vein system,and some of it can affect heart,causing obstruction of different degrees.In serious cases,it can lead to sudden death.Therefore,early diagnosis and accurate assessment can improve survival rate.Clinical manifestations of patients include difficulty breathing,chest tightness,chest pain,bilateral lower limb edema,abdominal distension and pelvic masses.Main diagnoses include localization diagnosis and qualitative diagnosis,imaging examination for localization diagnosis,and pathological examination for qualitative diagnosis.Intervention method and outcome are early surgery and early restoration of normal hemodynamics.Color Doppler ultrasound is a widely promoted ultrasound examination method in clinical practice,which has advantages of non-invasive,safe and high accuracy,and it is well received by patients and their families.If patients with respiratory and circulatory system symptoms,especially those with a history of uterine fibroids,should be highly vigilant about uterine intravenous leiomyomatosis,which is worth further popularization in clinical diagnosis.

关 键 词：彩色多普勒超声 静脉内平滑肌瘤病 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]