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目的全面分析对卵巢良性肿瘤行开腹保守性手术治疗的效果,了解手术后复发率、月经情况以及年轻患者的妊娠率,帮助临床医生决定患者的治疗方案,选择合适的手术方式。方法回顾性分析行开腹保守性手术治疗并经病理证实的149例原发性卵巢良性肿瘤患者的临床资料,按不同手术方法行归类分析,了解术后月经情况、复发率和妊娠率。结果卵巢良性肿瘤行保守性手术后的总复发率为4.24%,其中单侧剔除术后复发率为1.96%,双侧肿瘤剔除术后为10%,一侧附件切除术和一侧附件切除加一侧卵巢肿瘤剔除术后为4.26%。三种术式术后肿瘤的复发无显著性差异(P=0.319)。卵巢良性肿瘤行保守性手术后总的月经异常率为11.86%,行剔除术后总的月经异常率为8.54%,其中行单侧肿瘤剔除术后为3.92%,双侧肿瘤剔除术后为20%;一侧附件切除术和一侧附件切除加一侧卵巢肿瘤剔除术后的月经异常率为17.02%。单侧肿瘤剔除术后月经情况与双侧剔除术以及一侧附件切除术均有显著性差异(P=0.028;P=0.032)。有生育要求的患者术后的总妊娠率为88.64%。剔除术后总妊娠率为86.84%,其中行单侧剔除术后妊娠率为85.71%,双侧肿瘤剔除术后为90%;一侧附件切除术和一侧附件切除加对侧卵巢肿瘤剔除术后的妊娠率为100%。结论卵巢肿瘤剔除术是治疗年轻女性良性卵巢肿瘤的适当、有效的方法。在本组研究中,其术后复发率为4.23%,与附件切除术后无显著性差异。月经异常率为8.45%,优于附件切除术。对有生育要求的良性卵巢肿瘤患者行肿瘤剔除术后总妊娠率达86.84%。
Objective To comprehensively analyze the effect of conservative surgery on open benign ovarian tumors and to know the recurrence rate, menstruation and the pregnancy rate of young patients after operation, to help clinicians to decide the treatment plan for patients and to choose the appropriate surgical method. Methods The clinical data of 149 patients with primary benign ovarian tumors who underwent conservative surgery and were confirmed by pathology were retrospectively analyzed. The patients were classified according to different surgical methods and the postoperative menstrual status, recurrence rate and pregnancy rate were analyzed. Results The total recurrence rate of benign ovarian tumors was 4.24% after conservative surgery, of which the recurrence rate was 1.96% after unilateral excision and 10% after bilateral tumor resection. One side of adjuvant resection and one side of adjuvant resection Ovarian tumor on one side was 4.26% after resection. There was no significant difference in recurrence between the three surgical procedures (P = 0.319). The total number of abnormal menstruation after benign ovarian tumors was 11.86%. The total abnormal menstruation rate after the resection was 8.54%, which was 3.92% after unilateral tumor resection and 20% after bilateral tumor resection %; One side of the annex excision and removal of one side of the attachment plus one side of the ovarian tumor excision after menstrual abnormalities was 17.02%. There was a significant difference in menses after unilateral tumor resection with bilateral resection and excision of one side (P = 0.028; P = 0.032). Patients with fertility requirements after the total pregnancy rate was 88.64%. After excision, the total pregnancy rate was 86.84%, of which 85.71% after unilateral excision and 90% after bilateral tumor resection. One-sided attachment excision and one-sided attachment excision plus contralateral ovarian tumor excision After the pregnancy rate was 100%. Conclusion Ovarian tumor resection is an appropriate and effective method for the treatment of benign ovarian tumors in young women. In this study, the recurrence rate was 4.23%, no significant difference with the annex resection. Abnormal menstruation rate was 8.45%, better than the attachment resection. The total pregnancy rate after tumor resection was 86.84% in patients with benign ovarian tumors requiring fertility.