子宫颈巨大平滑肌瘤的临床分析

【】　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　Toinvestigatetheparticularityofdiagnosisandtreatmentforgiantuterinecervicalleiomyoma.　Methods　Weanalyzedtheclinicaldataof11patientswithgiantuterinecervicalleiomyomawhowereadmittedinourhospitalfromOctober2007toMarch2010.Theincidence,diagnosisandsurgicaltreatmentofthediseasewereevaluated.　Results　Ofthe11cases,ninewereretroperitonealleiomyomaandtwoweresubmucousleiomyoma.Therewereninemisdiagnosedcasesbeforeoperation,includingfivediagnosedaspelvicmass,oneasuterinesarcomaandthreeasuterinecorpusleiomyoma.Sixpatientsunderwentabdominalhysterectomyandbilateralsalpingo-oophorectomy;twounderwentabdominalhysterectomy;oneunderwentabdominalmyomectomy;oneunderwenttransvaginalmyomectomy;andoneunderwentabdominalmyomectomywithexcisionofcervicalstump.　Conclusion　Thegiantuterinecervicalleiomyomaiseasilymisdiagnosedpreoperativelyduetoitsspecialanatomicsite.Agoodexampleistheretroperitonealleiomyomainwhichthepelvicanatomicstructureischangedbecauseoftheextrusionofthetumoronotherpelvicorgans.Furthermore,injuriesandbleedingoftenhappenduringtheoperation.Consequently,sufficientpreoperativeassessmentandclearlyidentifyingregionalanatomicalrelationscaneffectivelyreducethedamageandbleedingduringtheoperation.