60例妊娠合并卵巢肿瘤临床资料分析

Ovarian tumor in pregnancy: A review of 60 cases

目的 研究妊娠合并卵巢肿瘤的临床特征,探讨其诊断方法和处理对策。 方法回顾性分析广西百色地区人民医院1991年1月-2000年1月10年间60例妊娠合并卵巢肿瘤病例的临床特征、诊治方法和妊娠结局。 结果 妊娠合并卵巢肿瘤的发生率为5.3‰(60/11 396)。其中卵巢良性肿瘤占45.0%(27/60),卵巢瘤样变占51.7%(31/60),卵巢恶性肿瘤占3.3%(2/60)。在所有卵巢肿瘤中,卵巢成熟型畸胎瘤最多见,占30.0%(18/60);第2位的是卵巢巧克力囊肿,占20.0%(12/60)。妊娠合并卵巢肿瘤常见的并发症为蒂扭转、肿物破裂和产道梗阻,发生率分别为11.7%(7/60)、3.3%(2/60)和3.3%(2/60)。60例中足月妊娠53例,早产4例,流产2例,人工流产1例。其中早产1例及流产2例病人发生急腹症行急诊手术,5例于孕16-22周行卵巢囊肿剥出术者,无1例发生流产。 结论 妊娠合并卵巢肿瘤以成熟型畸胎瘤最常见;为避免急腹症、流产和早产的发生,于妊娠16-22周行选择性手术是相对安全的。

Objective To study the clinical characters, diagnosis, and treatment of ovarian tumor in pregnancy. Methods 60 cases with ovarian tumor in pregnancy were reviewed. Results The incidence of pregnancy with Ovarian tumor was 5. 30 (60/11 396). Tumor-like lesions were the most common cases (31/60, 51.7%), followed by benign tumors (27/60, 45.0%)and malignant tumors (2/60, 3.3%). Mature cystic teratoma accounted for 30.0%, endometrioma cyst 20. 0%, adnexal torsion 11. 7%, the rupture of the tumor 3. 3%, and the arrest of descent of the presentation 3. 3%, Of the 60 cases, 53 cases were presented as term delivery, 4 premature birth, 2 spontaneous abortion, and 1 induced abortion. No spontaneous abortion occurred in the 5 patients who underwent laparotomy during 16 to 22 weeks of gestation. Conclusion To avoid adverse pregnancy outcome, excision of ovarian tumor during 16 to 22 weeks of gestation is recommended.