手术治疗妊娠期卵巢肿物对妊娠结局的影响

Effect of Surgical Treatment of Ovarian Cyst during Pregnancy on the Pregnant Outcome

目的探讨手术治疗妊娠期卵巢肿物的安全性及其对妊娠结局的影响。方法方便选取2012年1月—2015年12月于妊娠期在该院行卵巢肿物手术治疗的58例患者的临床资料进行回顾性分析。结果 58例患者中,在妊娠中期行择期手术者36例,早产1例;急诊手术22例,其中妊娠早期10例,流产2例;妊娠中期8例,流产1例;妊娠晚期4例,早产2例。18例行患侧附件切除术,40例行肿物剥除术。病理分型中良性肿物53例(91.3%),以成熟性畸胎瘤最多见,粘液性囊腺瘤次之;瘤样病变主要是子宫内膜异位囊肿和黄体囊肿;恶性肿瘤4例(6.8%),其中未成熟畸胎瘤2例,无性细胞瘤1例,粘液性囊腺癌1例;交界性肿瘤1例(1.7%)。结论妊娠合并卵巢肿物患者中,恶性肿瘤占一定比例,推荐有手术指征者在妊娠中期行择期手术可以改善妊娠结局。

Objective To study the safety of surgical treatment of ovarian cyst during pregnancy and its effect on the pregnant outcome.Methods 58 cases of patients with ovarian cyst during pregnancy in our hospital from January 2012 to December 2015 were conveniently selected for review.Results Of 58 cases,there were 36 cases with selective operation in the second trimester of pregnancy,1 case was premature labor;of 22 cases with emergency operation,10 cases were in the early pregnancy,2 cases were premature labor,8 cases were in the second trimester of pregnancy,1 case was premature labor;4 cases were in the third trimester of pregnancy,and 2 cases were premature labor,18 cases were treated with appendectomy of affected sides,40 cases were treated with cyst removal surgery,in terms of the pathological typing,there were 53 cases with benign tumors(91.3%),mostly mature teratoid tumor,followed by mucinous cystadenoma,and the tumor-like lesions were mainly endometrioma and corpus luteum cyst,4 cases were with malignant tumors(6.8%),including 2 cases with immature teratoma,1 case with dysgerminoma,1 case with mucinous cystadenocarcinoma and 1 case with borderline tumor(1.7%).Conclusion The malignant tumors hold a certain proportion in patients with pregnancy combined with ovarian masses,and the selective surgery for patients with surgical signs can improve the pregnant outcome.