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目的通过彩色多普勒超声对卵巢蒂扭转(OT)时血管蒂内的血流信号进行分级,联合腹痛激发-手术时间为OT时临床治疗方案的选择提供科学依据。方法回顾性分析31例因卵巢良性肿物蒂扭转在我院行腹腔镜(开腹)手术证实者,所有患者均于术前行经阴道(直肠)和(或)经腹超声检查,根据蒂内血流信号特征进行分级。记录腹痛激发-手术时间。结果血流信号Ⅰ级8例、Ⅱ级10例、Ⅲ级13例,卵巢存活率分别为100%、80%、30.8%。统计结果显示血流信号Ⅱ、Ⅲ级者卵巢存活率间存在差异,腹痛激发-手术时间是卵巢活性的影响因素之一。结论卵巢肿物蒂扭转时术中卵巢及肿物颜色不代表卵巢活性,所有扭转者均应先行复位;血流信号Ⅰ级者卵巢均存活,可根据患者情况择期手术,Ⅱ、Ⅲ级者卵巢活性与腹痛激发-手术时间有关,应行急诊手术,为挽救卵巢争取时机。
Objective To classify the blood flow signals in the pedicle of the ovary pedicled (OT) by color Doppler sonography and to provide a scientific basis for the selection of the clinical treatment plan when the operation time is OT. Methods Retrospective analysis of 31 cases of benign ovarian tumor torsion in our hospital laparoscopic surgery (laparotomy) were confirmed, all patients were transvaginal (rectal) and / or transabdominal ultrasonography preoperatively, according to Tien Blood flow signal characteristics were graded. Record abdominal pain - surgery time. Results There were 8 cases in grade Ⅰ, 10 cases in grade Ⅱ and 13 cases in grade Ⅲ. The ovarian survival rates were 100%, 80% and 30.8% respectively. Statistics show that blood flow signal Ⅱ, Ⅲ grade ovarian survival differences exist, abdominal pain - surgery time is one of the factors that affect ovarian activity. Conclusion Ovarian tumor torsion when the operation of ovarian and tumor color does not represent ovarian activity, all reverse should be first reset; blood flow signal grade Ⅰ ovaries are alive, according to the patient’s condition surgery, Ⅱ, Ⅲ grade ovarian Activity and abdominal pain inspired - surgery time, emergency surgery should be performed to save the ovaries to seize the opportunity.