本文選題：子宮源性靜脈內(nèi)平滑肌瘤病 + CT血管成像　； 參考：《中國(guó)實(shí)用外科雜志》2015年12期

【摘要】：目的總結(jié)子宮源性靜脈內(nèi)平滑肌瘤病(IVL)的診斷及治療方法。方法回顧性分析中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院2004年9月至2015年9月收治的7例IVL的臨床資料。結(jié)果 7例病人中5例行手術(shù)治療,2例行保守治療。手術(shù)病人術(shù)后病理學(xué)檢查均證實(shí)為子宮源性平滑肌瘤病。術(shù)中見5例病人均累及子宮靜脈、髂靜脈、卵巢靜脈及下腔靜脈,累及右心房4例,累及右心室及肺動(dòng)脈1例。5例病人IVL均來源于子宮腫瘤。隨訪結(jié)果:7例病人均獲隨訪。1例病人術(shù)后2個(gè)月因呼吸、循環(huán)功能衰竭死亡,2例未手術(shù)病人分別于出院后3年及4年死亡。1例低級(jí)別子宮內(nèi)膜間質(zhì)肉瘤病人術(shù)后1年復(fù)發(fā)。結(jié)論 IVL是一種少見但高危的疾病,手術(shù)復(fù)雜、困難,應(yīng)在臨床診斷上予以足夠的重視,防止漏診及誤診。術(shù)前應(yīng)詳細(xì)制定手術(shù)方案。
[Abstract]:Objective to summarize the diagnosis and treatment of uterine venous leiomyomatosis (IVL). Methods the clinical data of 7 cases of IVL admitted from September 2004 to September 2015 in the first affiliated Hospital of China Medical University were retrospectively analyzed. Results among 7 cases, 5 cases were treated by operation and 2 cases were treated conservatively. Postoperative pathological examination of all patients confirmed uterine leiomyomatosis. Intraoperative involvement of uterine vein, iliac vein, ovarian vein and inferior vena cava, right atrium in 4 cases, right ventricle and pulmonary artery in 1 case, IVL originated from uterine tumor in 5 cases. Results all 7 cases were followed up. 1 cases died of respiratory and circulatory failure in 2 months after operation. 2 cases died of non-operation in 3 years and 4 years after discharge. 1 case of low grade endometrial stromal sarcoma recurred 1 year after discharge. Conclusion IVL is a rare but high risk disease. The operation is complicated and difficult. We should pay enough attention to clinical diagnosis to prevent missed diagnosis and misdiagnosis. The operative plan should be worked out before operation.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院血管外科;
【分類號(hào)】：R737.33

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