急腹症手术中卵巢非良性肿瘤32例临床分析

摘要

Objective To analyze the clinical characteristics of ovarian non-benign tumors in gynecological acute abdomen.Methods Retrospectively analyze the clinical data,diagnosis and treatment options of thirty-two cases of malignant and borderline ovarian tumor which were confirmed by pathological results after operations.Results Among the patients with adnexal mass who underwent acute abdomen surgery,ovarian non-benign tumors accounted for 3.8％ (32/846),72％ of the tumors'diameter were greater than 10 cm,14 cases (44％) were operatively proven ovarian torsion and 12 cases (38％) were ovarian rupture.There were 15 cases of epithelial borderline tumors,8 cases of epithelial carcinomas,5 cases of malignant germ cell tumors and 4 cases of metastases.Adhesions in borderline tumors (1/15,6.7％) is lower than in malignant tumors (7/17,41.2％),the difference was statistically significant (P =0.041).Conclusion Ovarian non-benign tumors occurred in acute abdomen were often more than 10 cm in diameter; solid ingredients and rich blood within the adnexal mass were often showed on preoperative B ultrasound; borderline tumors were mostly smooth and torsion,while malignant tumors more for rupture or infection.%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10 cm,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10 cm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.