106例妊娠合并卵巢肿瘤及瘤样病变临床分析

发布时间：2019-01-24 22:09

【摘要】：目的探讨妊娠合并卵巢肿瘤及瘤样病变的诊断方式、病理类型和妊娠结局，以指导妊娠合并卵巢肿瘤及瘤样病变的临床诊治。 方法回顾性分析我院2009年1月~2012年12月收治的106例妊娠合并卵巢肿瘤及瘤样病变患者，根据分娩方式，将其分为阴道分娩组（A组）及剖宫产组（B组）；依据孕期超声检查结果，将B组分为分娩前诊断组（B1组）及术中诊断组（B2组）；根据诊断方式，分为超声诊断组（A组+B1组）和术中诊断组（B2组）。对A组孕期诊断情况和孕期卵巢肿物大小进行分析；对B1组孕期超声诊断、B1和B2组术中探查卵巢肿物大小及病理诊断类型进行分析；对超声诊断组（A+B1组）的诊断时间、超声检查肿瘤大小的变化进行分析。 结果本组妊娠合并卵巢肿瘤及瘤样病变患者占同期总分娩人数0.72%。106例患者分娩前诊断63例（59.43%），其中孕前诊断15例、孕早期诊断32例、孕中期诊断11例、孕晚期诊断5例，剖宫产同时发现43例（40.57%）。病理类型以卵巢子宫内膜异位囊肿最为多见（35.96%），其次为成熟性囊性畸胎瘤（24.72%）、卵巢黄体囊肿（10.11%）、黏液性囊腺瘤（7.87%）。经阴道分娩17例，剖宫产89例；单胎104例，双胎2例，获得新生儿107名；足月产100例，早产6例；新生儿窒息9例，死胎1例。 结论妊娠合并卵巢肿瘤及瘤样病变多数为良性病变，卵巢子宫内膜异位囊肿是妊娠合并卵巢肿瘤及瘤样病变常见的病理类型，，孕早中期的超声检查有助于诊断但有局限性，剖宫产同时双附件区的探查是必要的。妊娠结局良好，孕期绝大多数无需过多干预。
[Abstract]:Objective to investigate the diagnosis, pathological types and pregnancy outcome of ovarian neoplasms and tumor-like lesions in pregnancy, so as to guide the clinical diagnosis and treatment of ovarian neoplasms and tumor-like lesions in pregnancy. Methods from January 2009 to December 2012, 106 cases of pregnancy complicated with ovarian neoplasms and tumor-like lesions were retrospectively analyzed. According to the delivery mode, 106 cases were divided into vaginal delivery group (group A) and cesarean section group (group B). According to the results of ultrasound examination during pregnancy, group B was divided into pre-delivery diagnosis group (B1 group), intraoperative diagnosis group (B2 group), ultrasonic diagnosis group (A group B1 group) and intraoperative diagnosis group (B2 group). The diagnosis and size of ovarian mass during pregnancy were analyzed in group A, ultrasound diagnosis during pregnancy in group B1, the size of ovarian mass and the type of pathological diagnosis in group B1 and B2 during operation were analyzed. The diagnostic time and tumor size of ultrasonic diagnosis group (A B1 group) were analyzed. Results 63 cases (59.43%) were diagnosed before delivery, 15 cases were diagnosed before pregnancy, 32 cases were diagnosed in early pregnancy, 11 cases were diagnosed in second trimester of pregnancy. 5 cases were diagnosed in the third trimester of pregnancy, 43 cases (40.57%) were found at the same time by cesarean section. The most common pathological types were ovarian endometriosis cysts (35.96%), mature cystic teratoma (24.72%), ovarian luteal cyst (10.11%) and mucinous cystadenoma (7.87%). There were 17 cases of vaginal delivery, 89 cases of cesarean section, 104 cases of single fetus, 2 cases of twins, 107 cases of newborns, 100 cases of term delivery, 6 cases of premature delivery, 9 cases of neonatal asphyxia and 1 case of stillbirth. Conclusion most of pregnancy complicated with ovarian tumors and tumor-like lesions are benign lesions. Ovarian endometriosis cyst is a common pathological type of pregnancy complicated with ovarian tumors and tumor-like lesions. Ultrasound examination in the second trimester of pregnancy is helpful for diagnosis but limited. Exploration of both adnexal areas at the same time of cesarean section is necessary. Pregnancy outcome is good, the vast majority of pregnancy without too much intervention.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.25;R737.31


本文编号：2414909