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阔韧带巨大纤维平滑肌瘤合并血小板减少一例山西中医学院附属医院（０３００２４）李丽香患者女，６０岁。于２０年前妇科检查发现卵巢肿物约儿头大，近４～５年自觉肿物生长较快，伴腹满、尿频、行动不便，于１９９２年３月２３日入院。查体腹部明显膨隆并可扪及一囊性肿物，大小约妊娠７月＋。肝脾肋下触诊不满意。外阴正常，阴道通畅，分泌物少量。宫颈光滑。宫体偏右萎缩，于子宫左侧可触及肿物，表面光滑无压痛，活动度不大。宫颈涂片巴氏Ⅱ级。化验检查血象正常。胸透右侧膈肌升高，活动度减弱。Ｂ超提示：卵巢巨大囊实性肿物，囊腺瘤（内有钙化物）。４月７日在连续硬膜外麻醉下行剖腹探查术，纵形切开瘤体５ｃｍ，可见瘤壁较厚，肿物由呈蜂窝状结构。用吸引器吸出黄色清液约３０００ｍｌ，但未见肿物明显缩小。因病人术中情况不好，只作子宫颈上切除术。术中病人血压不稳，收缩压持续在６．０７～９．３３ｋＰａ，共加压输血２４００ｍｌ。病理报告：左侧阔韧带纤维平滑肌瘤，瘤组织伴发水样变性、玻璃样变及液化囊性变，部分瘤组织坏死伴感染出血。术后２０天病人突然口腔粘膜出现大小不等的血泡，阴道出血多于月经量，皮肤散在出血点。急查血小板为５万，出凝血时间为３分钟，急输同型血４０
Broad ligament giant fibroid leiomyoma with thrombocytopenia was the case of the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine (030024) Li Lixiang, female, 60 years old. In gynecological examination 20 years ago, ovarian tumors were found to be large, and conscious masses grew faster in the last 4 to 5 years. They were admitted to hospital on March 23, 1992, with full abdomen, frequent urination, and inconvenient mobility. Examination of the abdomen was obvious bulging and can be accompanied by a cystic mass, about the size of pregnancy in July +. Liver and spleen are not satisfied with the costal palpation. Normal vulva, vaginal patency, a small amount of secretions. The cervix is smooth. The right side of the uterine body atrophy, can touch the tumor on the left side of the uterus, the surface is smooth without tenderness, activity is not. Pap smear grade II. Laboratory tests were normal. The right chest muscles of the chest were elevated and the activity was weakened. B-Tip: Solid cystic solid tumors in the ovary, cystic adenomas (with calcifications). On April 7th, under continuous epidural anesthesia, laparotomy was performed. When the tumor was longitudinally incised to 5 cm, the wall of the tumor was thick, and the tumor was a honeycomb structure. Approximately 3000 ml of the yellow liquid was aspirated with an aspirator, but no tumor was noticeably reduced. Because of the poor condition of the patient during the operation, only upper cervical resection was performed. Intraoperative blood pressure instability, systolic pressure continued in 6.07 ~ 9.33kPa, a total of 2400ml blood pressure transfusion. Pathology report: On the left side of the broad ligament fibroid leiomyoma, the tumor tissue with watery degeneration, hyaline degeneration and cystic degeneration, and some tumor necrosis with infection bleeding. On the 20th day after the operation, the patient suddenly had oral buccal membranes of varying sizes on the oral mucosa, vaginal bleeding was more than the amount of menstruation, and the skin was scattered on the bleeding site. An urgent check of 50,000 platelets, a clotting time of 3 minutes, and an emergency blood loss of 40