青春期卵巢肿瘤临床分析

发布时间：2018-05-28 21:04

本文选题：青春期 + 卵巢肿瘤　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：目的：分析总结青春期卵巢肿瘤的临床特点、诊断及治疗,为其提高其早期诊断率，改善预后提供依据。方法：回顾性分析我院2007年1月至2012年11月间收治的105例10-19岁卵巢肿瘤患者的临床资料，分析其发病情况、临床特点、病理类型、辅助检查、治疗方法及随访情况。结果：青春期卵巢肿瘤多以腹痛就诊共51例，占48.57%，，27例无任何症状仅体检发现，占25.71%。术前B超提示卵巢肿瘤直径大于10cm时恶性及交界性肿瘤的发生率增加，应用超声图像评分系统进行评分，在术前判断卵巢肿瘤性质上有明显作用。105例青春期卵巢肿瘤中，良性肿瘤93例占88.57%、恶性肿瘤8例占7.61%、交界性肿瘤4例占3.80%。组织学分型中，生殖细胞肿瘤51例占48.57%、瘤样病变27例占25.71%、上皮性肿瘤25例占23.80%、性索间质细胞肿瘤1例占0.95%。105例患者均行手术治疗且术后病理证实，术中冰冻与术后病检符合率为94.28%。良性肿瘤中88例行卵巢囊肿剥除术，5例行患侧附件切除术；4例交界性肿瘤中3例行卵巢肿瘤剥除，1例行行子宫+右附件+大网膜+阑尾切除术。8例恶性肿瘤均行保留生育功能的手术，其中6例术后给予PVB或PEB化疗。结论：青春期卵巢肿瘤就诊时主要以腹痛为主，其次为体检发现，应重视对青春期女性的妇科普查。B超有助于术前判断卵巢肿瘤的性质应作为诊断的首选辅助检查。肿瘤标记物检查应作为卵巢肿瘤常规检查，结合临床症状可更好的判定肿瘤性质。青春期卵巢肿瘤患者的手术方式无论良恶性均应尽量保留生育功能，首次发现青春期女性附件区如有囊性包块,考虑为卵巢瘤样病变的可暂不手术，连续动态复查B超。恶性肿瘤术后应联合规范化疗，严密随访术后恶性肿瘤的患者。
[Abstract]:Objective: to analyze and summarize the clinical features, diagnosis and treatment of adolescent ovarian neoplasms in order to improve the early diagnosis rate and improve the prognosis. Methods: the clinical data of 105 patients with ovarian neoplasms aged 10-19 years from January 2007 to November 2012 were analyzed retrospectively. The incidence, clinical features, pathological types, auxiliary examinations, treatment methods and follow-up were analyzed. Results: 51 cases of pubertal ovarian tumors were diagnosed with abdominal pain, accounting for 48.57% of 27 cases without any symptoms, only physical examination was found, accounting for 25.71%. B-mode ultrasound showed that the incidence of malignant and borderline tumors was increased when the diameter of ovarian tumors was larger than 10cm. The ultrasound image scoring system was used to evaluate the nature of ovarian tumors. There were 93 benign tumors (88.57), 8 malignant tumors (7.61%) and 4 borderline tumors (3.80%). According to histological classification, 51 cases of germ cell tumor (48.57%), 27 cases of tumor-like lesion (25.71%), 25 cases of epithelial tumor (23.80 cases) and 1 case of sex cord interstitial cell tumor (0.955.105 cases) were treated by operation and proved by pathology after operation. The coincidence rate between intraoperative freezing and postoperative disease detection was 94.28%. Of the benign tumors, 88 cases underwent excision of ovarian cysts and 5 cases underwent resection of the affected adnexa. 3 cases of borderline tumors were treated with ovarian tumor excision. 1 case underwent appendectomy of right adnexal omentum appendectomy. 8 cases of malignant tumors were performed. Surgery that preserves fertility, Among them, 6 cases received PVB or PEB chemotherapy after operation. Conclusion: abdominal pain is the main factor in the diagnosis of adolescent ovarian tumors, followed by physical examination. The gynecological survey of adolescent women should be paid attention to. B-mode ultrasound is helpful to determine the nature of ovarian tumors before operation and should be regarded as the first choice of auxiliary examination in the diagnosis of ovarian tumors. Tumor markers should be used as routine examination of ovarian neoplasms, combined with clinical symptoms can better judge the nature of the tumor. For the first time, if there is cystic mass in the adnexal region of puberty female, it is considered that the ovarian tumor-like lesion can not be operated on for a while, and continuous dynamic reexamination of B-mode ultrasound is carried out. Postoperative malignant tumor should be combined with standard chemotherapy, closely follow up postoperative patients with malignant tumor.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

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