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目的探讨弥漫性子宫平滑肌瘤病(DUL)的临床症状、影像学检查、病理特征和手术方式,以期提高对该病的认识。方法回顾性分析14例术后经病理证实的非妊娠期弥漫性子宫平滑肌瘤病的患者的临床资料,分析患者的症状、影像学检查、术前诊断、手术方式、术中所见及术后随访情况。结果 14例患者中,月经量增多至贫血13例,无症状1例。彩超提示为多发子宫肌瘤13例,单发子宫肌瘤1例。术前均被误诊为子宫肌瘤。7例行子宫肌瘤切除术,7例行全子宫切除术。术中仅1例见边界欠清的单发结节,余13例均见子宫肌层、宫腔布满结节。肌瘤切除术后患者月经量恢复正常,2例足月妊娠分娩。结论 DUL临床表现以月经增多为主,术前诊断率低,手术是最主要的治疗方法,多采用全子宫切除术,对于要求保留生育功能的年轻患者,可以选择经腹子宫肌瘤切除术。
Objective To investigate the clinical symptoms, imaging examination, pathological features and surgical methods of diffuse uterine leiomyomatosis (DUL) in order to improve the understanding of the disease. Methods The clinical data of 14 patients with pathologically confirmed diffuse uterine leiomyomataetesis were analyzed retrospectively. The patients’ symptoms, imaging examination, preoperative diagnosis, operation method, intraoperative findings and operation were analyzed. Follow-up situation. Results In 14 patients, menstruation increased to anemia in 13 cases and asymptomatic in 1 case. Choi ultrasound prompted multiple uterine fibroids in 13 cases, single uterine fibroids in 1 case. Preoperative misdiagnosed as uterine fibroids. 7 cases of myomectomy, 7 cases of hysterectomy. Only one case of intraoperative see solitary border nodules, more than 13 cases were seen in the myometrium, uterine cavity full of nodules. Myomactomy patients with normal menstruation, 2 cases of full-term pregnancy delivery. Conclusions The clinical manifestations of DUL are mainly menorrhagia, preoperative diagnosis rate is low, surgery is the most important treatment method, and the use of total hysterectomy, for young patients who require reproductive function retention, you can choose abdominal myomectomy.