小儿卵巢囊肿40例临床分析

Clinical aspects of 40 cases of children with ovarian cysts

目的:分析小儿卵巢囊肿的诊断和治疗方法。方法:回顾性分析我院2012年1月至2014年12月间40例小儿卵巢囊肿患儿的临床资料。结果:发病年龄26 d^14岁,平均9岁。左侧卵巢囊肿22例,右侧17例,两侧1例。38例行手术治疗,其中20例行腹腔镜手术,18例行传统开腹手术。1例非手术治疗因住院期间囊肿自行消失,另1例因囊肿小且无症状行保守治疗。6例卵巢囊肿蒂扭转致卵巢坏死行附件切除术,1例快速病理报告为无性细胞瘤,行附件切除术。31例行卵巢囊肿剥除术。病理报告为囊性成熟性畸胎瘤、浆液性囊腺瘤、黏液性囊腺瘤、混和性囊腺瘤、内膜样囊肿等。结论:儿童卵巢囊肿的临床症状少有特异性,其确诊及鉴别诊断依赖于影像学检查,β-h CG检测对评估囊肿良恶性有较大意义;卵巢囊肿蒂扭转后卵巢能否保留取决于早期诊断、及时手术和肿瘤性质。腹腔镜手术治疗良性卵巢囊肿有其优势,但对于恶性者应谨慎选择术式。

Objective： To analyze the diagnosis and treatment of ovarian cysts in children. Methods： A retrospective study of 40 children diagnosed with ovarian cysts from January 2012 to December 2014 was un- dertaken. All the patients are from The Second Affiliated Hospital ＆ Yuying Children＇s Hospital of Wenzhou Medical University. Results： The ages of the girls are varied from 26 days to 14 years old, with a mean age of 9 years old. 22 cases were on the left, 17 on the right and 1 on both sides. 38 cases accepted surgical interven- tion （20 cases were done by laparoscopy and 18 cases were done by laparotomy）. One case without operation treatment for the cyst disappeared during hospitalization, another case underwent conservative treatment for the cyst was small and asymptomatic. 6 cases underwent adnexectomy for ovary necrosis, and another 1 case underwent this operation method for the fast pathologic diagnosis was dysgerminoma. Thirty-one cases under- went oophorocystectomy retenting of ovarian cyst. The pathological report mature cystic teratoma, serous cyst- adenoma, mucinous cystadenoma, mixed cystadenoma, endometrioid cyst. Conclusion： Clinical symptoms of ovarian cyst in children are not special, and its diagnosis and differential diagnosis rely on image examination. AFP and 13-HCG detection in blood have great significance in evaluating the Ovarian cyst＇s differentiation of benign and malignant. Whether the ovary can retain or not after pedicle torsion of ovarian cyst should depends on the early diagnosis, timely operation and the nature the treatment of benign ovarian cyst, but we should be a vicious one. of the tumor. Laparoscopic surgery has its advantages in careful to choose the operating method when it comes to