妇女功能性卵巢囊肿破裂出血手术干预的危险因素及治疗策略

Risk factors and treatment strategies of surgical intervention for women with functional ovarian cyst rupture and bleeding

目的分析妇女功能性卵巢囊肿破裂出血手术干预的相关危险因素,且总结相应的治疗策略。方法回顾性分析2017年8月至2020年8月于本院确诊的100例功能性卵巢囊肿破裂出血患者的临床资料,根据其治疗方式的不同分为A组(n=72)与B组(n=28)。A组采用保守治疗,B组采用手术治疗,分析比较两组临床特征及CT影像资料,对可能影响功能性卵巢囊肿破裂出血手术干预的相关因素进行单因素分析和多因素Logistic回归分析。结果两组年龄、婚姻、体重指数(BMI)、生育史、卵巢囊肿大小、就诊时收缩压及血红蛋白浓度比较差异无统计学意义;A组就诊时舒张压明显高于B组,盆腔积液深度明显低于B组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,就诊时舒张压及盆腔积液深度为影响功能性卵巢囊肿破裂出血手术干预的独立因素(P<0.05)。舒张压和盆腔积液深度最佳临界值分别为69 mmHg和5.6 cm,若患者同时伴2个危险因素,其手术干预率为81.45%,若伴有其中1个危险因素,其手术干预率为18.42%,若未伴有危险因素,其手术干预率为3.22%。结论功能性卵巢囊肿破裂出血患者大部分可考虑进行保守治疗,但对于就诊时舒张压偏低和/或腹腔大量积血者则可考虑予以手术干预。

Objective The related risk factors of surgical intervention for women with functional ovarian cyst rupture and bleeding are analyzed,and the corresponding treatment strategies are summarized.Methods Clinical data of 100 patients diagnosed with functional ovarian cysts rupture and bleeding of from August 2017 to August 2020 were retrospectively analyzed,and they were divided into group A(n=72)and group B(n=28)according to different treatment methods.Group A were treated conservatively,group B were treated with surgery(n=28),the clinical features and CT imaging data were compared and analyzed,and surgical interventions that may affect functional ovarian cyst rupture and bleeding,single factor analysis and multivariate Logistic regression analysis were performed on the related factors.Results There were no significant differences in age,marriage,BMI,fertility history,ovarian cyst size,systolic blood pressure and hemoglobin concentration between the two groups.The diastolic blood pressure in the group A was significantly higher than that in the group B,and the depth of pelvic effusion was significantly lower than that in the group B,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis,the independent factors affecting the surgical intervention of functional ovarian cyst rupture and bleeding were the diastolic blood pressure and the depth of pelvic effusion(P<0.05).The optimal cut-off values for diastolic blood pressure and pelvic effusion depth are 69 mmHg and 5.6 cm,respectively.If the patient was accompanied by two risk factors,the surgical intervention rate sas 81.45%,and if one of the risk factors was accompanied,the surgical intervention rate was 18.42%,if there was no risk factors,the surgical intervention rate was 3.22%.Conclusion For patients with functional ovarian cyst rupture and bleeding,conservative treatment can be considered for most patients,but surgical intervention can be considered for patients with low diastolic blood pressure and/or large abdominal hemorrhage at the time of consultation.