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李 璇,辛世杰
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
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
李 璇,辛世杰. 子宫源性静脉内平滑肌瘤病7例临床分析[J]. 中国实用外科杂志, DOI: 10.7504/CJPS.ISSN1005-2208.2015.12.15.
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https://www.zgsyz.com/zgsywk/EN/Y2015/V35/I12/1311