• 四川大学华西第二医院妇产科(成都,610041);
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【摘要】 目的  探讨子宫颈巨大平滑肌瘤在其诊断及治疗上的特殊性。 方法  对2007年10月-2010年3月收治的11例子宫颈巨大平滑肌瘤患者的临床资料进行分析,对其发病率,诊断和手术治疗进行评价。 结果  11例子宫颈巨大平滑肌瘤中黏膜下2例,腹膜后9例。术前9例出现误诊,其中误诊为盆腔包块5例,子宫体肌瘤3例,子宫肉瘤1例。6例行经腹子宫全切加双附件切除,2例行经腹子宫切除术,1例行经腹肌瘤挖除术,1例行经阴道肌瘤摘除术,1例行经腹肌瘤挖出加宫颈残端切除术。 结论  子宫颈巨大平滑肌瘤由于其位置的特殊性,尤其是凸向腹膜后的肌瘤,由于盆腔器官被挤压,使盆腔解剖结构发生改变,术前易被误诊。且手术过程中易出现损伤及出血,因此术前估计充分,术中仔细认清各器官解剖关系,可有效地减少术中损伤和控制出血。
【Abstract】 Objective  To investigate the particularity of diagnosis and treatment for giant uterine cervical leiomyoma. Methods  We analyzed the clinical data of 11 patients with giant uterine cervical leiomyoma who were admitted in our hospital from October 2007 to March 2010. The incidence, diagnosis and surgical treatment of the disease were evaluated. Results  Of the 11 cases, nine were retroperitoneal leiomyoma and two were submucous leiomyoma. There were nine misdiagnosed cases before operation, including five diagnosed as pelvic mass, one as uterine sarcoma and three as uterine corpus leiomyoma. Six patients underwent abdominal hysterectomy and bilateral salpingo-oophorectomy; two underwent abdominal hysterectomy; one underwent abdominal myomectomy; one underwent transvaginal myomectomy; and one underwent abdominal myomectomy with excision of cervical stump. Conclusion  The giant uterine cervical leiomyoma is easily misdiagnosed preoperatively due to its special anatomic site. A good example is the retroperitoneal leiomyoma in which the pelvic anatomic structure is changed because of the extrusion of the tumor on other pelvic organs. Furthermore, injuries and bleeding often happen during the operation. Consequently, sufficient preoperative assessment and clearly identifying regional anatomical relations can effectively reduce the damage and bleeding during the operation.

引用本文: 冯丹,方芳. 子宫颈巨大平滑肌瘤的临床分析. 华西医学, 2011, 26(3): 385-387. doi: 复制