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目的探讨阴道平滑肌瘤患者的临床表现、病理特征、诊断和治疗。方法1996～2004年间四川大学华西第二医院妇产科收治的阴道平滑肌瘤患者24例,均经病理检查证实,对其临床资料进行回顾性分析。结果阴道平滑肌瘤病程较长(平均1.2年),临床症状不明显。肌瘤多为单发(22/24)、实性(18/24),直径≤3cm的占62.5%。多位于阴道上段,共17例,阴道前壁16例,发病部位和临床表现有关。超声检查可帮助诊断和治疗。手术剔除肌瘤为首选治疗方案。结论阴道平滑肌瘤发病隐匿,妇科检查扪及阴道包块,月经的异常、腰腹疼痛、尿路刺激、便秘均是其主要临床表现,超声可协助诊断。阴道平滑肌瘤有恶变的潜能性,应警惕其肉瘤样变。
Objective To investigate the clinical manifestations, pathological features, diagnosis and treatment of patients with vaginal leiomyomata. Methods Twenty-four patients with vaginal leiomyoma treated by Department of Obstetrics and Gynecology, Second West China Hospital of Sichuan University from 1996 to 2004 were confirmed by pathological examination and their clinical data were retrospectively analyzed. Results Vaginal leiomyoma longer duration (average 1.2 years), clinical symptoms are not obvious. Myoma mostly single (22/24), solid (18/24), diameter ≤ 3cm accounted for 62.5%. Mostly located in the upper vagina, a total of 17 cases, 16 cases of anterior vaginal wall, the incidence of parts and clinical manifestations. Ultrasonography can help diagnose and treat. Surgery to remove fibroids is the preferred treatment. Conclusions Incidence of vaginal leiomyoma is obscure, gynecological examination palpable vaginal mass, abnormal menstruation, lumbar and abdominal pain, urinary tract irritation and constipation are the main clinical manifestations. Ultrasound may be helpful in diagnosis. Vaginal leiomyoma has the potential of malignant, should be wary of its sarcomatoid change.