中国实用外科杂志

中国实用外科杂志

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子宫源性静脉内平滑肌瘤病7例临床分析

李    璇，辛世杰   

  1. 中国医科大学附属第一医院血管外科，辽宁沈阳 110001
  • 出版日期:2015-12-01 发布日期:2015-12-01

  • Online:2015-12-01 Published:2015-12-01

摘要：

目的    总结子宫源性静脉内平滑肌瘤病（IVL）的诊断及治疗方法。方法    回顾性分析中国医科大学附属第一医院2004年9月至2015年9月收治的7例IVL的临床资料。 结果    7例病人中5例行手术治疗，2例行保守治疗。手术病人术后病理学检查均证实为子宫源性平滑肌瘤病。术中见5例病人均累及子宫静脉、髂静脉、卵巢静脉及下腔静脉，累及右心房4例，累及右心室及肺动脉1例。5例病人IVL均来源于子宫肿瘤。随访结果：7例病人均获随访。1例病人术后2个月因呼吸、循环功能衰竭死亡，2例未手术病人分别于出院后3年及4年死亡。1例低级别子宫内膜间质肉瘤病人术后1年复发。 结论    IVL是一种少见但高危的疾病，手术复杂、困难，应在临床诊断上予以足够的重视，防止漏诊及误诊。术前应详细制定手术方案。

关键词: 子宫源性静脉内平滑肌瘤病, CT血管成像

Abstract:

Intravenous leiomyomatosis: A clinical analysis of 7 cases        LI Xuan，XIN Shi-jie. Department of Vascular Surgery，the First Hospital of China Medical University，Shenyang 110001，China
Corresponding author：XIN Shi-jie，E-mail：sjxin@mail.cmu.edu.cn
Abstract    Objective    To investigate the diagnosis and treatment of intravenous leiomyomatosis (IVL). Methods    The clinical data of 7 cases of IVL admitted between September 2004 and September 2015 in the First Hospital of China Medical University were analyzed retrospectively. Results    Five cases of the 7 cases underwent surgical treatment, 2 cases underwent conservative treatment. All the 5 cases had pathological diagnosis of IVL. Five cases involved the uterus vein，iliac vein，vena ovarica and inferior vena cava; 4 cases involved right atrium; 1 case involved right cardiac ventrium and pulmonary artery. IVL of 5 cases originated from uterous tumor. Seven cases were followed. One case died of respiratory and circulatory failure in postoperative 2 months. Two cases of non operation died in postoperative 3 and 4 years respectively. One case of low grade endometrial stromal sarcoma recurred in postoperative 1 year. Conclusion    IVL is a kind of rare and fatal diseases that should be paid more attention to the diagnosis and treatment in order to avoid misdiagnosing. A detailed operation program should be made before the operation.

Key words: intravenous leiomyomatosis, CT venography