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目的探讨急腹症手术中卵巢非良性肿瘤患者的临床特点。方法回顾性分析2000年1月至2011年12月北京协和医院收治的妇科急腹症手术后病理证实为卵巢恶性或交界性肿瘤32例,总结其临床特点及诊治方法。结果因妇科急腹症手术的附件包块846例患者中,卵巢非良性肿瘤32例,占3.8%(32/846);72%肿瘤直径大于10cm,其中扭转14例(44%),破裂12例(38%)。32例卵巢非良性肿瘤患者中,卵巢上皮性交界性肿瘤15例,上皮性癌8例,恶性生殖细胞肿瘤5例,转移瘤4例。交界瘤术中粘连率(1/15,6.7%)低于恶性肿瘤(7/17,41.2%),差异有统计学意义(P=0.041)。结论卵巢非良性肿瘤发生急腹症多见于直径大于10cm者,术前超声提示包块内有实性成分血流丰富应警惕恶性可能;交界瘤多为光滑的肿瘤扭转,而恶性肿瘤多为破裂或感染。
Objective To investigate the clinical features of benign ovarian tumors in acute abdomen surgery. Methods Retrospective analysis from January 2000 to December 2011 Beijing Union Medical College Hospital gynecologic acute abdomen surgery pathologically confirmed 32 cases of ovarian malignant or borderline tumors, summarizes its clinical features and diagnosis and treatment methods. Results Among the 846 cases with accessory mass in gynecologic acute abdomen surgery, 32 cases of non-benign ovarian tumors accounted for 3.8% (32/846); 72% of tumors were larger than 10 cm in diameter, of which 14 cases (44%) were twisted and 12 Example (38%). Among the 32 patients with benign ovarian tumors, 15 were ovarian epithelial borderline tumors, 8 were epithelial carcinomas, 5 were malignant germ cell tumors and 4 were metastatic tumors. The adhesion rate (1 / 15,6.7%) in borderline tumor was lower than that in malignant tumors (7 / 17,41.2%), the difference was statistically significant (P = 0.041). Conclusions Acute abdomen with benign ovarian tumors is more common in patients with diameter greater than 10cm. Preoperative ultrasound suggests that the solid components in the mass should be alert to the possibility of malignancy. The borderline tumors are mostly smooth tumors with malignant tumors mostly ruptured Or infected.