卵巢皮样囊肿临床特点和腹腔镜手术治疗效果分析

Laparoscopic Surgical Management and Clinical Characteristics of Ovarian Dermoid Cysts

目的:研究卵巢皮样囊肿的临床特点和评估腹腔镜手术治疗的安全性和有效性。方法:回顾性分析63例进行开腹或腹腔镜手术的的卵巢皮样囊肿患者的临床资料[腹腔镜治疗组29例(观察组),开腹手术组34例(对照组)],分析其临床特点,比较两组患者手术时间、住院时间、肿瘤直径、术中失血量、囊液外溢率、肠功能恢复时间等各项临床指标。结果:48例(76.2%)患者无症状,于查体时发现。15例(23.8%)患者以腹部胀痛就诊,其中包括5例卵巢囊肿蒂扭转患者。11例(17.5%)处于围绝经期,48例(76.2%)处于生育期,4例(6.3%)处于青少年期。卵巢囊肿发生在双侧、左侧及右侧的比例分别为14.2%、42.9%及42.9%。5例(7.9%)发生卵巢囊肿扭转,瘤体直径中位数为10.4 cm。CA125中位数为16.60 U/m L,CA199中位数为17.75 U/m L。观察组和对照组患者手术时间和肿瘤直径方面比较,差异均无统计学意义(P>0.05),但观察组住院时间、术中失血量、肠功能恢复方面、术后病率均明显优于开腹手术组(P<0.05)。观察组囊液外溢率为89.7%,而对照组为6.0%,差异有统计学意义(P<0.05)。结论:卵巢皮样囊肿症状不明显,多发于生育期妇女,好发于单侧卵巢,瘤体>6 cm扭转的风险增加,CA125和CA199在卵巢囊性成熟性畸胎瘤患者中并没有明显的增高,腹腔镜手术治疗皮样囊肿是安全、有效的。

Objective：To analyze the clinical characteristics of ovarian dermoid cysts and to evaluate the efficacy and safety of laparoscopic surgery for ovarian fibromas.Method：We reviewed the records of 63 consecutive women who underwent laparoscopic or laparotomic surgeries and whose final histopathological diagnoses were ovarian mature cystic teratomas in Heze Municiple Hospital,Gynaecology from 2014 to 2015[laparoscopic surgery（n=29,the observation group）, laparotomy（n=34,the control group）],correlated clinical indexes of two groups were compared.Result：76.2% of the infections showed no symptom.However,three patients showed positive results when they performed uterine myoma scan,and 1 case has been detected when she did the ectopic pregnancy scan.23.8% of the infections felt obvious abdominal pains,including 5 cases who suffered torsion of the pedicle of ovarin cyst.17.5% were in peri-menopasusal,76.2% were in growth season and 6.3% were teenagers.There were 14.2% who had ovary cyst on both sides,42.9% on the left and 42.9% on the right.We discovered 5 cases who had torsion of the pedicle of ovarian cyst,had tumor body size roughly around 10.4 cm.The median of CA125 was 16.60 U/m L,the median of CA199 was 17.75 U/m L.The observation group had the advantages of shorter hospital stay and less intraoperatve blood soss and faster return of bowel activities compared to the control group（P〈0.05）.The hydatid fluid spilling of the observation group was 89.7%,the control group was 6.0%,there was statistical significance（P〈0.05）.Conclusion：Dermoid cyst symptom is obscurity and predilection in unilateral ovary and crinosity in growth season women.When tumor diameter was〉 6 cm,the risk of torsion is raising.CA125 and CA199 don＇t raise in ovarian dermoid cysts.Laparoscopic surgery for ovarian dermoid cysts is efficacy and safety.