静脉内平滑肌瘤病20例临床分析  

Clinical analysis of 20 cases of intravenous leiomyomatosis

作　　者：李瑞娟 孟艳红[2] Li Ruijuan;Meng Yanhong(School of Clinical Medicine,Jining Medical University,Jining Shandong 272013;Department of Ultrasound,Affiliate Jining Medical College,Jining Shandong 272029,P.R.China)

机构地区：[1]济宁医学院临床医学院,山东济宁272013 [2]济宁医学院附属医院超声科,山东济宁272029

出　　处：《中国计划生育和妇产科》2024年第11期105-108,112,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：山东省中医药科技项目(项目编号:M2022248)。

摘　　要：目的 分析静脉内平滑肌瘤病的临床特点、影像学特征、治疗及预后随访情况。方法 回顾性分析2022年6月至2023年10月期间济宁医学院附属医院20例静脉内平滑肌瘤病患者的临床病理资料,总结静脉内平滑肌瘤病的影像学特征及其临床症状与复发风险的相关性,并分析漏诊、误诊的影响因素。结果 患者平均年龄(45.8±3.2)岁,影像学表现以子宫增大、盆腔肿物伴静脉占位为主,临床表现与肿瘤受累部位密切相关,8例(40%)既往有子宫肌瘤史或子宫肌瘤切除术史,2例(10%)未绝经,所有患者均行手术治疗且术后病理证实为静脉内平滑肌瘤病。1例(5%)失访,1例(5%)复发,18例(90%)随访未见复发,目前仍在随诊中。结论 静脉内平滑肌瘤病需借助影像学联合病理金标准方能正确做出诊断,且该病易复发,首选手术治疗,术后需要定期随访。Objective To summarize the clinical features,imaging features,treatment and prognosis of intravenous leiomyomatosis.Methods The clinicopathological data of 20 patients from the Affiliated Hospital of Jining Medical College from June 2022 to October 2023 were retrospectively analyzed.The imaging features of intravenously leiomyomatosis and the correlation between clinical features and recurrence risk were summarized,and the influencing factors of misdiagnosis and missed diagnosis were analyzed.Results The mean age of the patients was(45.8±3.2)years old.The imaging manifestations were mainly uterine enlargement,pelvic masses with venous occupation,and the clinical manifestations were related to the site of tumor involvement,8 patients(40%)had a history of uterine fibroids or hysteromyomectomy,and 2 patients(10%)were premenopausalm,all patients underwent surgical treatment and were pathologically confirmed as intravenous leiomyomatosis.One case(5%)was lost to follow-up,one case(5%)relapsed,and 18 cases(90%)had no recurrence and were still under follow-up.Conclusion The correct diagnosis of intravenous leiomyomatosis can only be made with the help of imaging combined with pathological gold standard,and the disease is prone to recurrence,surgery is the first choice for treatment,and regular follow-up is required after surgery.

关 键 词：静脉内平滑肌病 影像学检查 误诊 手术 复发 

分 类 号：R711.74[医药卫生—妇产科学]