174例附件扭转患者的临床分析

Clinical analysis of 174accessories torsion patients

目的了解附件扭转手术患者的临床特点,不同手术方式的影响因素及其效果。方法回顾性分析疑诊或手术确诊为附件扭转患者174例。分析其临床特征、手术方式及术后恢复情况。结果共有14例怀疑卵巢囊肿蒂扭转的患者经抗炎补液支持治疗后好转未行手术治疗,其中8例(57.1%)合并妊娠;160例手术治疗的患者,病理证实卵巢囊肿蒂扭转144例,2例卵巢冠囊肿扭转,14例输卵管系膜囊肿/输卵管扭转;卵巢冠囊肿及输卵管囊肿/输卵管扭转患者的手术方式均是切除手术。卵巢囊肿蒂扭转144例患者中,26例(18.1%)采用保留附件的卵巢复位及囊肿剥除手术纳入A组,患者无术后感染发热情况;118例(81.9%)切除附件纳入B组;A组的年龄、蒂扭转程度、蒂扭转时间均明显小于B组(P<0.05)。结论卵巢囊肿蒂扭转患者可以尝试保留卵巢的复位手术,无严重并发症出现。

Objective To understand clinical features of accessories torsion patients, and influencing factors and effects by different surgical measures. Methods A retrospective analysis was made on clinical features, surgical measures and postoperative recovery in 174 patients with suspected or diagnosed accessories torsion. Results There were totally 14 improved cases with suspected ovarian cyst torsion receiving no operation therapy after anti-inflammatory supplement treatment, and 8 cases （57.1%） among them were complicated with pregnancy. Among 160 patients who receiving operation therapy, there were 144 cases with pathologically verified ovarian cyst torsion, 2 cases with parovarian cyst torsion and 14 cases with mesosalpinx cyst/tubatorsion. Resection operation was the basic operation measure for parovarian cyst torsion andmesosalpinx cyst/tubatorsion. Among 144 cases with ovarian cyst torsion, 26 cases （18.1%） of them as group A receiving ovary reset and cyst removal operation with accessories preservation, and they had no postoperative fever; the other 118 cases （81.9%） as group B received accessories removal operation. The group A had all less age, torsion deqree, and torsion time than the group B （P〈0.05）. Conclusion Ovarian preservation reset operation can be applied for ovarian cyst torsion patients, without severe adverse reactions.