手术治疗妊娠合并卵巢肿瘤109例临床分析

目的探讨妊娠合并卵巢肿瘤的临床特点及诊治措施,以期指导临床工作。方法对2000～2010年收治的109例经手术及病理诊断确诊的妊娠合并卵巢肿瘤患者的临床资料及妊娠结局进行回顾性分析。结果 109例患者中56例无明显症状,有症状者多表现为下腹痛、腹胀、阴道流血等;均行手术治疗(囊肿剔除术或患侧附件切除术),病理示卵巢良性肿瘤59例,占54.13%(以成熟性囊性畸胎瘤最多见),瘤样病变49例,占44.95%(以黄体囊肿和巧克力囊肿多见),交界性卵巢肿瘤1例,占0.92%;术后妊娠活产率为94.50%。结论妊娠合并卵巢肿瘤以卵巢良性肿瘤为主,多无明显症状,应注意早期诊治,适时的手术干预不影响妊娠结局,以肿瘤剔除术为主要手术方式。

Objective To investigate the clinical features, diagnosis and treatment of ovarian tumor during pregnancy. Methods The clinical materials of 109 pregnant patients with ovarian tumor, admitted for and diagnosed by surgery, were retrospectively analyzed. Results 56 cases had no obvious presentations. Those who had discomforts mostly presented lower abdominal pain, abdominal distention, vaginal bleeding, etc; Operations, either cystectomy or salpingo-oophorectomy, were performed on all subjects; According to pathologic examinations, ovarian benign tumors accounted for 54.13% （most were mature cystic teratomas）, tumoroid lesions 44.95% （most were luteal cysts or endometriomas） and borderline ovarian tumor 0.92%; Postoperative live birth rate was 94.5%.Conclusion Ovarian tumors during pregnancy mostly present as benign ones and most sufferers have no obvious discomforts. Early diagnosis and treatment should be recommended. Timely surgery will not impair the pregnancy outcome. The main surgical method is cystectomy.