妇科手术后盆腔包裹性积液及卵巢冠囊肿的超声引导下介入性治疗

Ultrasound-Guided Interventional Therapy of Postoperative Pelvic Fluid Collection and Parovarian Cysts

目的 :探讨妇科术后盆腔包裹性积液及卵巢冠囊肿进行超声引导下介入性治疗的方法与疗效。材料和方法 :妇科术后盆腔包裹性积液患者 16例 ,共 19个囊腔 ,卵巢冠囊肿 13例 ,分别在经阴道及经腹壁超声引导下行穿刺抽液及酒精凝固治疗 ,囊内液病理检查瘤细胞 ,治疗后患者行超声随访检查 ,观察疗效。治疗不彻底者在 3～ 5个月后进行第二次治疗。结果 :所有囊内液均未发现瘤细胞 ,包裹性积液患者除 3例初次治疗不彻底行二次治疗外 ,余随访中均发现积液消失 ;卵巢冠囊肿 12例行酒精凝固治疗的全部一次治疗成功 ,随访中囊肿消失 ,妊娠合并卵巢冠囊肿蒂扭转的 1例 ,经抽液治疗后腹痛消失 ,妊娠继续。结论 :盆腔包裹性积液和卵巢冠囊肿的超声引导下穿刺抽液酒精凝固治疗 ,患者痛苦小 ,疗效好 ,经济、方便 ,值得大力推广应用。

Purpose: To evaluate the feasibility and therapeutic efficiency of ultrasound guided interventional therapy of postoperative pelvic fluid collection and parovarian cysts. Materials and methods: 16 cases had pelvic fluid collection after gynecologic operations with 17 cysts and 2 locules, and 13 cases of parovarian cysts were treated with ultrasound guided aspiration and ethanol injection transabdominally or transvaginally. Cytologic examination was carried out right before treatment. All cases were followed with ultrasound exam to check the therapeutic effects. Second therapy was conducted in 3 to 5 months in 3 cases not completely cured. Results: All cytologic examinations were negative. All but 3 cases with pelvic fluid collection were cured and 3 received a second therapy. 12 patients with parovarian cyst treated with ethanol got cured and on follow up their cysts disappeared. One case of pregnancy complicated by torsion of parovarian cyst was simply aspirated without ethanol. The abdominal pain disappeared right after treatment and the pregnancy went on smoothly. Conclusion: Ultrasound guided aspiration and ethanol sclerotherapy in pelvic fluid collection and parovarian cyst cases was proved effectire. It is worthy of advocate of its use in view of its economy, convenience and painlessness.