论文部分内容阅读
目的探讨腹腔镜诊治直径<5cm的术前诊断为良性卵巢囊肿的临床意义。方法腹腔镜诊治术前诊断为良性单侧卵巢囊肿119例(同时行肌瘤剔除等手术的患者除外),其中直径<5cm卵巢囊肿32例,≥5cm87例。直径<5cm卵巢囊肿的患者术前均为有症状或观察3次B超提示囊肿未消失,每次B超间隔2个月以上或CA125升高。比较两组的病理类型、术中情况、术后并发症及排气时间。结果直径<5cm卵巢囊肿中84.4%(27/32)需手术治疗,以畸胎瘤和巧克力囊肿居多,该组术中肿物破裂率、手术时间、电凝止血率均明显低于≥5cm组(均P<0.05),出血≤20mL的患者所占比率明显高于≥5cm组(P<0.05)。两组的赘生性肿瘤率、术中粘连、排气时间及并发症无统计学差异(均P>0.05)。结论对于直径<5cm卵巢囊肿的患者,若有症状或观察3次B超提示囊肿未消失,每次B超间隔2个月以上或CA125升高者,行腹腔镜诊治是必要的、安全的,并可减少术中肿物破裂率、缩短手术时间、减少出血、保护卵巢功能,但要避免不必要的手术。
Objective To investigate the clinical significance of laparoscopic diagnosis and treatment of benign ovarian cysts with a diameter of less than 5cm. Methods Laparoscopic diagnosis and treatment of benign unilateral ovarian cyst in 119 cases (excluding myomectomy and other operations except patients), of which ovarian cysts <5cm 32 cases, ≥ 5cm 87 cases. Patients with ovarian cysts less than 5 cm in diameter were either symptomatic or observed 3 times before surgery. The cyst did not disappear. Each time B-ultrasound was separated by more than 2 months or CA125 was elevated. The pathological types, intraoperative conditions, postoperative complications and exhaust time were compared between the two groups. Results 84.4% (27/32) of the ovarian cysts with diameter less than 5 cm needed surgical treatment, mostly teratomas and chocolate cysts. The rate of tumor rupture, operation time and electrocoagulation in this group were significantly lower than those in ≥5 cm group (All P <0.05), and the proportion of patients with ≤20 mL of bleeding was significantly higher than that of ≥5cm (P <0.05). Neoplasm tumor rate, intraoperative adhesions, exhaust time and complications were not statistically different between the two groups (all P> 0.05). Conclusions For patients with ovarian cysts <5cm in diameter, if there are symptoms or observation of 3 times of B-ultrasound, the cyst does not disappear, laparoscopic diagnosis and treatment is necessary for every B-ultrasound interval more than 2 months or CA125. It is safe, And can reduce intraoperative tumor rupture rate, shorten the operation time, reduce bleeding, protect ovarian function, but to avoid unnecessary surgery.