幼少女盆腔包块误诊15例分析  

An analysis on misdiagnoses of 15 children and adolescents with pelvic mass

作　　者：阮晓红[1] 钟开运[1] 杨爱莲[1] 

机构地区：[1]广东省江门市中心医院妇科,广东江门529070

出　　处：《河北医学》2004年第9期788-790,共3页Hebei Medicine

摘　　要：目的 :分析幼少女盆腔包块误诊的原因 ,并提出避免误诊的方法。方法 :回顾分析我院1 999年至 2 0 0 3年收治的 1 8岁以下盆腔包块误诊病例 1 5例 ,年龄 4～ 1 8岁 ,平均 1 4 .4岁 ,其中生殖道先天性畸形 8例 ,输卵管妊娠 2例 ,卵巢囊肿蒂扭转、盆腔结核、输卵管脓肿、子宫肉瘤、阑尾脓肿各 1例。结果 :1 5例误诊病例以生殖道先天性发育异常最多见 ,占 5 3% (8 1 5 )。 1 5例患者多以急腹症为表现 ,占 6 7% (1 0 1 5 ) ,往往同时伴泌尿、消化道症状。全部患者均经手术治疗 ,盆腔结核患者术后予抗结核治疗 ,子宫肉瘤患者在外院手术 ,化疗 1疗程后死亡 ,其余病例均治愈出院。结论 :幼少女盆腔包块诊断时应注意年龄阶段 ,9岁以后应考虑到特有的疾病 ,如生殖道先天畸形等。幼少女生殖道肿瘤以卵巢肿瘤多见 ,可发生在任何年龄 ,但不应忽视一些少见的生殖道恶性肿瘤的可能性。对“月经”异常、下腹痛的患者 。Objective: To analyze the cause of misdiagnoses of pelvic mass in children and adolescents. Method: 15 girls under 18 years old with pelvic mass who were misdiagnosed between 1999 to 2003 were reviewed. The age ranged from 4 to 18 years old with an average of 14.4 years. 8 of them with congenital abnormality of reproductive tract, 2 of them with tubal gestation, one each with ovarian cyst pedicle torsion, tubal abscess, sarcoma of uterus, abscess of appendix, pelvic tuberculosis respectively. Result: Congenital abnormality of reproductive tract made the largest proportion to other diseases in 15 cases. Most patients of 15 cases presents as acute abdomen(67%)and often accompanied with urinary and gastrointestinal syndrome. All the patients were treated by surgery. The patient with pelvic tuberculosis was given standard anti-tuberculosis therapy. The patient with sarcoma of uterus was treated by surgery in other hospital and died after a cycle chemotherapy. Except this patient, all recovered satisfactorily. Conclusion: Age is important when diagnoses are made in girls. Some special disease such as congenital abnormality of reproductive tract should be taken into account in girls above 9 years old. Any rare genital malignant tumor should not be neglected although the ovarian neoplasms make the major proportion. Sexual history should be paid more attention to the adolescents with abnormal menses and lower abdominal pain.

关 键 词：盆腔包块 误诊 少女 

分 类 号：R711[医药卫生—妇产科学]