目的：探讨子宫静脉内平滑肌瘤病的临床特点和治疗情况。方法回顾性分析2005年9月至2015年9月收治的33例经病理确诊的子宫静脉内平滑肌瘤病患者的临床资料。结果患者平均年龄(41．79±8．68)岁；26例(78．8%)有生育史；8例(24．2%)患者有子宫相关手术史；25例(75．8%)患者无临床症状,在超声检查或妇科检查时发现；术前无确诊病例,术中肉眼观多数呈肌瘤样外观,7例行术中冰冻病理检查但无明确诊断病例,所有患者均由术后病理诊断。40岁以上患者多数(13/17)行全子宫+双附件切除术。术后4例失访,随访的29例患者平均随访(15．07±19．72)个月,8例(27．6%)复发。结论子宫静脉内平滑肌瘤病发病率低,复发率高；育龄妇女多见,临床表现无特异性,诊断主要依靠病理检查；治疗上以手术为主,术中需仔细观察,术后要加强随诊。%Objective: To investigate clinical characteristics and treatment of intravenous leiomyomatosis. Methods: The clinical data of 33 patients with pathologically confirmed intravenous leiomyomatosis in our hospital from September 2005 to September 2015 were retrospectively analyzed. Results: The mean age of the patients was (41. 79±8. 68) years. Twenty six patients(78. 8%) had delivery history. Eight patients ( 24. 2%) had a history of uterine-related surgery. Twenty five patients ( 75. 8%) had no clinical symptoms and were diagnosed by ultrasound examination or gynecological inspection. None of them was diagnosed preoperatively. The tumor-like tissues were appeared during operation in the majority patients. The intraoperative frozen biopsy were performed but no clear diagnosis in 7 patients. All patients was diagnosed by postoperative pathology. All patients over 40 years old were performed hysterectomy and bilateral oophorotomy. Four patients were lost to follow up after surgery. The average follow-up time was ( 15. 07 ± 19. 72 ) months for 29 patients. Eight patients(27. 6%) had relapsed. Conclusions: Intravenous leiomyomatosis is a low incidence disease with no specific clinical features,and it mostly affects the women with childbearing age. Diagnosis mainly depends on pathology, and surgery is main treatment. Postoperative follow-up should be carried out routinely.
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