妊娠合并卵巢肿物130例临床分析

A study on pregnancy outcome and the influence on fetus in 130 cases of pregnancy associate with adnexal masses

目的探讨妊娠合并卵巢肿物的诊断、临床表现和特征以及孕期处理方式对妊娠结局及胎儿的影响。方法对南京医科大学附属南京妇幼保健院2007年1月至2011年4月间收治并经手术证实及病理诊断的130例妊娠合并卵巢肿物病例,进行回顾性分析。结果妊娠合并卵巢肿物患者130例中76例(58.5%)于孕早中期发现;孕期发生蒂扭转13例(10%),破裂5例(3.85%),其中直径5～10cm的肿物更易发生并发症(P<0.05),孕中期亦较孕早、晚期更易发生并发症(P<0.05)。妊娠合并卵巢肿物患者130例,肿物数为148个,其中良性肿瘤患者87例,良性肿瘤数100个,以生殖细胞来源肿瘤多见,畸胎瘤最常见。卵巢交界性肿瘤2例,卵巢恶性肿瘤3例。130例手术患者,无流产病例,1例放弃胎儿,余129例胎儿均健康。结论在孕期适时进行手术干预对于妊娠合并卵巢肿瘤的患者及胎儿是安全的。

Objective To investigate the influences on pregnancy outcomes and fetuses, the analysis was implemented on diagnosis, clinical symptoms,the features and the treatments of 130 pregnant eases associated with adnexal masses. Meth- ods As an experimental method, the retrospective analysis has been chosen in this research. 130 cases with adnexal mas- ses during pregnancy has been involved in this study, which had been treated, operated and pathologically diagnosed in Nanjing Maternal ＆ Child Health Hospital affiliated to Nanjing Medical University between January 2007 and April 2011. Results 58. 5% （76 cases） of the 130 cases were diagnosed during the first or the second trimesters. Torsion happened in 13 out of them which constitute 10% in total, and rupture happened in another 5 cases （3.85 % ）. With the diameter of tumor increase from 5em to 10cm,the incidence of complications increased correspondingly （P 〈 0.05 ）, and the inci- dence of complications was significantly higher during the second trimester compared with the first and last trimester （ P 〈 0. 05 ）. Among the 130 cases,87 eases of them are benign. Most of benign tumors originate from germ cell, and teratoma is most common type. 2 cases of borderline ovarian tumors were diagnosed, while another 3 cases are ovarian malignant tumors. Among 130 cases with no abortion,only one gave up the fetus, and the remaining 129 fetuses were healthy. Con- dusion Timely operation is safe for both of the mothers who associated with adnexal masses and their fetuses.