妊娠合并卵巢肿瘤和子宫肌瘤的临床诊断及治疗

Clinical diagnosis and treatment of patients with ovarian tumor in pregnancy and myoma of uterus

目的:分析妊娠合并卵巢肿瘤和子宫肌瘤的临床特征、诊断及其治疗。方法:回顾性分析2010年1月-2012年8月我院产科妊娠合并卵巢肿瘤59例、妊娠合并子宫肌瘤(肌瘤直径大于4cm)患者265例临床资料,分析妊娠合并卵巢肿瘤、妊娠合并子宫肌瘤患者的临床资料、诊断时间、治疗等。结果:妊娠合并卵巢肿瘤患者平均孕次以及无临床自觉症状百分率显著高于妊娠合并子宫肌瘤患者(P<0.05);妊娠合并卵巢肿瘤患者彩超诊断准确率89.83%,妊娠合并子宫肌瘤患者彩超诊断准确率为85.28%,两组比较,差异无统计学意义(P>0.05);在59例妊娠合并卵巢肿瘤患者中,53例行剖宫产,剖宫产术中同时实施手术患者53例,占剖宫产人数的100.00%,实施卵巢肿瘤剥除加卵巢成形术患者43例(81.13%)、行患侧附件切除术患者10例(18.87%);在265例妊娠合并子宫肌瘤患者中,164例行剖宫产,剖宫产术中同时行肌瘤剔除术患者135例,占剖宫产人数的82.32%。结论:妊娠合并卵巢肿瘤患者无明显的临床症状;彩超诊断对与妊娠合并卵巢肿瘤、妊娠合并子宫肌瘤具有着重要的应用价值;在严格控制患者病情、掌握手术指征的情况下,剖宫产同时行手术治疗是一种良好的治疗方式。

Objective： To investigate the clinical features, diagnosis and treatment of patients with ovarian tumor in pregnancy and myoma of uterus. Methods： To a retrospectively analyze clinical data of 59 patients with myoma of ute- rus, pregnancy 265 patients with ovarian tumor. Results：The patients with ovarian tumor in pregnancy average preg- nancy and no clinical symptoms were significantly higher than in patients with pregnancy complicated with uterine my- oma（P 〈 0.05 ）. Color Doppler ultrasound in the diagnosis of patients with ovarian tumor in pregnancy, the accuracy rate was 89.83% ,pregnancy complicated with uterine myoma patients with color Doppler ultrasound diagnostic accu- racy rate was 85.28% （P 〉 0.05 ）. 59 cases of pregnancy with ovarian tumor,53 cases of cesarean section, cesarean section at the same time the implementation of 53 cases of patients with cesarean section operation, accounting for 100% of the number of ovarian tumor, stripping and ovary forming of 43 patients （81.13 % ）, 10 cases treated with re- section of lateral attachment（ 18.87% ）. In 265 cases of pregnancy complicated with uterine myoma patients, 164 ca- ses of cesarean section, cesarean section and myomectomy in patients with cesarean section in 135 cases, accounting for 82.32%. Conclusion： Patients with ovarian tumor in pregnancy had no obvious clinical symptoms, color Doppler ultrasound in diagnosis of ovarian tumors, and associated with pregnancy and myoma of uterus pregnancy has important value.