247例卵巢成熟囊性畸胎瘤临床分析

A Clinical Analysis of Ovarian Teratoblastoma

目的:对卵巢成熟囊性畸胎瘤的临床特点及术后妊娠情况、月经情况进行探讨。方法:对我院1991年1月—2 0 0 2年12月收治的卵巢成熟囊性畸胎瘤2 4 7例病例的临床特点、手术情况、合并妊娠的处理及愈后情况,以及术后的妊娠及月经情况进行分析。结果:卵巢成熟囊性畸胎瘤占同期卵巢良性肿瘤的38.2 4 % ,80 .97%的病人年龄位于2 0岁～4 0岁之间。肿瘤大多数为单侧,约为88.6 6 %。肿瘤平均直径为7.4 7cm ,在直径(4～10 )cm之间的肿瘤占大多数。肿瘤单房占绝大多数,为90 .18%。发现肿瘤的方法通常是妇检。肿瘤的病理组成成份最多见的是脂肪、毛发。肿瘤最常见的并发症是蒂扭转。6 .0 7%的畸胎瘤患者合并妊娠,在孕中期手术妊娠结局良好。开腹行单侧畸胎瘤剔除术,术后不孕率与正常人群无差异。行单侧肿瘤剔除术对月经的影响比行单侧附件切除术小(P <0 .0 1)。结论:成熟畸胎瘤是生育年龄妇女最常见的卵巢肿瘤,蒂扭转为其最常见的并发症,且多发生在中等大小的肿瘤。行卵巢畸胎瘤剔除术能有效地保留育龄妇女的卵巢功能。合并畸胎瘤的妊娠妇女在孕中期行手术治疗畸胎瘤,妊娠结局良好。

Objective: To describe clinical feature and the postoperative pregnancy condition in patients with ovarian teratoblastoma. Methods: The 247 cases with ovarian teratoblastoma were analyzed. The data were collected from our hospital between Jon 1991 and Dec 2002. Results: The 80.97% of all age was at 20 to 49 years old following the ovarian teratoblastoma. The set of the disease was occurred at the one side of ovary (88.66%) . 90.18% teratoblastoma was the one ventricle. No difference of acyesis was found between the normal women and the postoperative people who had had an ovarian teratoblastoma. Among all cases the menorrhea status in patients with tumor unilateral excision was better than that in patients with unilateral adnexectomy (P<0.01 ).Conclusions:It is not difficult for the second pregnancy in women to have excised the ovarian teratoblastoma.