经腹一期手术联合介入切除累及下腔静脉的平滑肌瘤病一例并文献复习  

A Case Report and Literature Review of One Stage Surgery Combined with Interventional Resection of Leiomyomatosis Involving the Inferior Vena Cava

作　　者：朱晓瑛 焦今文[2] 杜秀珍 尤师静 郭明金[3] 胡维昱[4] 王科[5] 潘维敏[6] 姚勤[2] 

机构地区：[1]青岛大学医学部,山东 青岛 [2]青岛大学附属医院妇科,山东 青岛 [3]青岛大学附属医院血管外科,山东 青岛 [4]青岛大学附属医院肝胆外科,山东 青岛 [5]青岛大学附属医院泌尿外科,山东 青岛 [6]青岛大学附属医院麻醉科,山东 青岛

出　　处：《临床医学进展》2022年第10期9006-9013,共8页Advances in Clinical Medicine

摘　　要：目的:探讨经腹一期手术联合介入切除累及下腔静脉的平滑肌瘤病的可行性及诊治要点。方法:对1例经腹一期手术联合介入切除累及下腔静脉的血管内平滑肌瘤病的患者的临床资料进行报道并对相关文献进行回顾性分析。结果:本例患者为绝经后女性,因静脉内平滑肌瘤(3期,累及下腔静脉)入院经两次多学科诊疗(MDT)后行下腔静脉球囊放置及取出术 + 经腹筋膜外全子宫切除术 + 双侧输卵管–卵巢切除术 + 下腔静脉切开取栓术。手术成功,术后无并发症,术后随访11月无复发。结论:静脉内平滑肌瘤可呈蠕虫状生长入下腔静脉引起患者死亡,一期开腹联合开胸手术或分期手术创伤大,并发症多,经腹一期手术联合介入切除累及下腔静脉的平滑肌瘤安全可行,但如何正确把握手术适应证还有待进一步探索和研究。Objective: To investigate the feasibility and key points of diagnosis and treatment of one stage transabdominal operation combined with interventional resection of leiomyomatosis involving in-ferior vena cava. Methods: The clinical data of a patient with endovascular leiomyomatosis involving inferior vena cava were reported and the related literatures were retrospectively analyzed. Results: The patient was a postmenopausal woman who was admitted to hospital for intravenal leiomyoma (stage 3, involving inferior vena cava) and underwent two MDTS, followed by placement and remov-al of inferior vena cava balloon + Transabdominal extrafascial hysterectomy + Bilateral salpin-go-oophorectomy + Thrombectomy of inferior vena cava. The operation was successful and there were no postoperative complications. No recurrence occurred during the follow-up for 11 months. Conclusion: IVL is vermicular grow into the inferior vena cava can cause patients died, the issue of open joint open chest surgery or staging surgery trauma, complication. One stage surgery combined with interventional resection of leiomyomatosis involving the inferior vena cava is safe and feasible, but how to correctly grasp the operation indication remains to be further exploration and research.

关 键 词：静脉内平滑肌瘤病 一期手术 介入医学 多学科诊疗(MDT) 

分 类 号：R737.33[医药卫生—肿瘤]