30例恶性卵巢肿瘤手术分析

An Analysis of 30 Operations on Malignant Ovary Tumors

目的 :了解卵巢恶性肿瘤临床特点 ,探讨早期诊断及治疗方式。方法 :回顾性分析 1993年 5月至 1999年 7月收治的 30例卵巢恶性肿瘤病例 ,其中上皮性卵巢癌 14例 ,转移性腺癌 9例 ,卵泡膜细胞瘤 2例 ,颗粒细胞瘤 2例 ,内胚窦瘤 1例 ,无性细胞瘤 1例 ,癌肉瘤 1例。结果 :患者中位年龄45 .5岁。临床分期 期 13例 , 期 5例 , 期 1例 , 期 11例。 期 13例中 11例行子宫、两附件、大网膜切除、盆腔淋已结清扫术 ,2例生殖细胞肿瘤年龄 2 2岁者仅切除患侧肿瘤 ,保留子宫、对侧附件 , 期 5例均行子宫两附件切除 ,盆腔淋巴结清除术 ,大网膜切除 , 期行肿瘤灭减术 , 期 11例中除 1例盆腔广泛转移 ,阴道转移行剖腹探查 ,组织活检术外 ,其余均行肿瘤灭减术。术后均给予不同方案的化疗。结论 :卵巢肿瘤患者早期大多有腹胀 ,下坠感症状 ,应及早就医 ,提高生存率。卵巢肿瘤的病员要到有病理快速切片的医院手术 ,以避免二次手术。胃肠道转移肿瘤预后差 ,术中应认真探查两侧卵巢 ,以发现亚临床转移灶 。

Objective:To find out characteristic symptoms of malignant ovary tumors and probe for ways to diagnose and treat at their early stage.Method:30 cases of malignant ovary tumors were analysed taken into the hospital from May 1993 to July 1999.Of the 30 patients,14 are epithelial ovary tumors,9 the mestaisis of adenoid ones,2 the cacell ones,2 granular cell ones,1 endodermal sinus ones,1 asexual cell carcinoma and 1 carcinosarcoma.Result:Of the patients,whose average age is 45.5,13 patients are in Ⅰ stage and 5 in Ⅱ stage according to the clinical stage while 1 in Ⅲ stage and 11 in Ⅳ stage.A uterine,two uterine appendages,greater omentum,pelvic lynph nodules exenteration were removed respectively from the 11 patients of the 13 in Ⅰ stage,on the rest of which a cancericidal was done in the affected region of the reproductive cell tumors,remaining the uterine and its normal appendage.As for the five patients in Ⅱ stage,two uterine appendages,pelvic lynph nodules extenteration,greater omentum were excised separately.A cancericidal was also done in the tumors in Ⅳ stage and the same was done with the patients in Ⅳ stage except the one with the mestaisis of pelvic and uterus tumor,in which an exploratory laparotomy and a tissue biopsy were used.Different chemotherapy protocals were given to all the patients after operation.Conclusion:Based on the results,an abdominal distron and bearing down are the characteristic symptoms of the ovary tumors at the early stage.Patients should go as early as possible to hospital where there is a frozen section so that a secondary operation could be avoided and thus the survival rate is raised.The prognosis on the mestaisis of intestinal tract tumors is usually unfavorable,Therefore an exploration into bilateral ovaries should be conducted during operation so that a subclinical mestaisis can be identified in order to raise early diagnosis rate.