腹腔镜手术治疗妊娠合并卵巢囊肿蒂扭转26例报告

发布时间：2018-07-09 13:38

本文选题：妊娠 + 卵巢囊肿蒂扭转　；参考：《中国微创外科杂志》2017年12期

【摘要】：目的探讨腹腔镜手术治疗妊娠合并卵巢囊肿蒂扭转的经验。方法 2009年1月~2016年12月对26例妊娠合并卵巢囊肿蒂扭转急诊行腹腔镜手术,根据术中情况,腹腔镜下行囊肿剥除术或患侧附件切除术。术后早期妊娠患者黄体酮20~40 mg肌肉内注射,1次/d,连续3 d;中晚期妊娠患者硫酸镁静脉滴注,5 g/d,连续3 d。通过患者再次入院记录、门诊或电话随访妊娠结局。结果 26例均完成腹腔镜手术。术中发现11例卵巢坏死行患侧附件切除术,其余15例行患侧卵巢肿物剥除术。手术时间20~60 min,平均47.8 min。术中出血10~400 ml,平均88.8 ml。住院时间2~16 d,平均5.8 d。术后21例(80.8%)保胎治疗。术后26例均未出现流产、早产症状,继续妊娠至足月分娩,13例顺产,13例剖腹产;新生儿出生后1、5 min Apgar评分8~10分。结论腹腔镜手术治疗妊娠合并卵巢囊肿蒂扭转对妊娠是安全的,但对于大囊肿、妊娠晚期患者手术困难。
[Abstract]:Objective to explore the experience of laparoscopic surgery in the treatment of ovarian cyst pedicle torsion in pregnancy. Methods from January 2009 to December 2016, 26 cases of pregnancy complicated with ovarian cyst pedicle torsion were treated by laparoscopic surgery. Patients with early pregnancy received intramuscular injection of progesterone 2040mg once a day for 3 days, and patients with middle and late pregnancy received magnesium sulfate intravenously for 5 g / d for 3 days. Pregnancy outcomes were recorded by readmission, outpatient or telephone follow-up. Results Laparoscopic surgery was performed in all 26 cases. 11 cases of ovarian necrosis were treated with appendectomy, the other 15 cases were treated with ovarian tumor excision. The operation time was 20 ~ 60 min (mean 47.8 min). Intraoperative bleeding was 10400 ml with an average of 88.8 ml. The average hospitalization time was 5.8 days. Postoperative 21 cases (80.8%) were treated with fetal preservation. There were 13 cases of spontaneous delivery and 13 cases of caesarean section in 13 cases of continuous pregnancy to term delivery, and the score of 1 ~ 5 min Apgar after birth was 810 ~ 10 in all the 26 cases without miscarriage and premature delivery. Conclusion Laparoscopic surgery is safe for pregnancy with ovarian cyst pedicle torsion, but for large cysts, late pregnancy is difficult.
【作者单位】：首都医科大学附属北京妇产医院妇科;
【分类号】：R713.8

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