CAJ | 학술논문

目的：探讨子宫静脉内平滑肌瘤病（IVL）的临床特征和处理方法，提高对该病的认识。方法对已确诊的3例子宫静脉内平滑肌瘤病患者的临床资料进行回顾分析，并复习相关文献。结果子宫IVL患者与子宫肌瘤的临床表现相同，表现为经量增多、经期延长、盆腹腔包块。术前无特异性的诊断方法，术中发现肌壁间静脉内可见蜂窝状、蠕虫状结节，延伸至宫壁。宫旁静脉增粗，静脉内可见索条状组织，质韧如橡皮样。病理检查是确诊的依据。本病典型病理改变为静脉内见蠕虫样、条索状瘤体，可抽出，镜下呈良性平滑肌瘤的形态，不侵袭静脉壁。结论子宫IVL是具有恶性生物学行为的良性疾病，术前诊断率极低，术中能否正确诊断、处理关系到患者预后，需注重术中探查，提高术中确诊率。
목적：탐토자궁정맥내평활기류병（IVL）적림상특정화처리방법，제고대해병적인식。방법대이학진적3례자궁정맥내평활기류병환자적림상자료진행회고분석，병복습상관문헌。결과자궁IVL환자여자궁기류적림상표현상동，표현위경량증다、경기연장、분복강포괴。술전무특이성적진단방법，술중발현기벽간정맥내가견봉와상、연충상결절，연신지궁벽。궁방정맥증조，정맥내가견색조상조직，질인여상피양。병리검사시학진적의거。본병전형병리개변위정맥내견연충양、조색상류체，가추출，경하정량성평활기류적형태，불침습정맥벽。결론자궁IVL시구유악성생물학행위적량성질병，술전진단솔겁저，술중능부정학진단、처리관계도환자예후，수주중술중탐사，제고술중학진솔。
Objective To investigate the clinical characteristics and treatment of intravenous leiomyomatosis of the uterus(IVL) in order to improve the understanding of it. Methods The clinical data of three cases of IVL patients was ret-rospectively analyzed, and relevant literatures were reviewed. Results The clinical symptoms of the 3 cases of IVL were identical to that of the uterine fibroids, which presented as the increase of menstrual volume, extended menstrual period and pelvic mass. There was no specific diagnostic method before operation. Pathological examination was the basis of diag-nosis. Typical pathological changes were intravenous visible web-like or worm-formed nodules, funicular tumors, which could be pulled out. Microscopically, it could be in the shape of a benign leiomyoma and did not invade the venual wall. Conclusion The IVL is a benign disease with malignant biological behavior. The preoperative diagnosis rate is extreme-ly low. Intra-operative correct diagnosis is related to the prognosis. We need to pay attention to intraoperative exploration, in order to increase the rate of intraoperative diagnosis.