卵巢囊肿B超影像对腹腔镜手术的指导意义

Guidance of preoperative ultrasonography of ovarian cyst to laparoscopic procedure

为判断卵巢囊肿B超影像对腹腔镜手术的指导意义,对有手术指征的卵巢囊肿56例进行了B超检查并摄片,记录其大小、活动度、肿瘤内回声、囊壁是否规则、囊壁厚度及张力等。结果显示:45例B超回声良好,囊壁<3mm、活动好的病例病理证实为卵巢腺瘤及卵巢冠囊肿,多数行囊液吸出、囊壁剥出,少数行囊肿切除,手术时间<60min。11例B超回声不均质病例中,大多囊壁厚>3mm且不规则。其中3例子宫内膜异位症中2例因盆腹腔广泛粘连而中转开腹,2例浆膜下子宫肌瘤,6例畸胎瘤。手术时间60～120min。表明如B超示囊肿透声及活动良好,囊壁规则,壁厚<3cm则多为卵巢单纯囊肿,腹腔镜手术省时有效。如囊肿回声不均质、活动差,囊壁厚且不规则者应考虑到术中处理有一定难度,要有中转开腹的充分准备。

The authors examined 56 patients with ovarian cyst using ultrasound so as to find guidance of ultrasonography of ovarian cyst before laparoscopic ovarian operation. Diameter, moving range, echo, density of cyst and regulation or irregulation, thickness of cystic wall were recorded in ultrasonography. The results showed that cyst filling fluid, cystic wall less than 3mm, movable cyst is easy to perform by laparoscopic technique. As opposite to above condition of cyst, the management of the cyst with laparoscopic method is difficult and likely converted into laparotomy.