卵巢肿瘤保守性手术治疗149例临床研究  

Retrospective Study of Conservative Surgery on 149 Women with Ovarian Tumors

作　　者：何科[1] 巫岳鹏[1] 梅卓贤[1] 余利云[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510089

出　　处：《国际医药卫生导报》2006年第18期4-7,共4页International Medicine and Health Guidance News

摘　　要：目的全面分析对卵巢良性肿瘤行开腹保守性手术治疗的效果,了解手术后复发率、月经情况以及年轻患者的妊娠率,帮助临床医生决定患者的治疗方案,选择合适的手术方式。方法回顾性分析行开腹保守性手术治疗并经病理证实的149例原发性卵巢良性肿瘤患者的临床资料,按不同手术方法行归类分析,了解术后月经情况、复发率和妊娠率。结果卵巢良性肿瘤行保守性手术后的总复发率为4.24%,其中单侧剔除术后复发率为1.96%,双侧肿瘤剔除术后为10%,一侧附件切除术和一侧附件切除加一侧卵巢肿瘤剔除术后为4.26%。三种术式术后肿瘤的复发无显著性差异(P=0.319)。卵巢良性肿瘤行保守性手术后总的月经异常率为11.86%,行剔除术后总的月经异常率为8.54%,其中行单侧肿瘤剔除术后为3.92%,双侧肿瘤剔除术后为20%;一侧附件切除术和一侧附件切除加一侧卵巢肿瘤剔除术后的月经异常率为17.02%。单侧肿瘤剔除术后月经情况与双侧剔除术以及一侧附件切除术均有显著性差异(P=0.028;P=0.032)。有生育要求的患者术后的总妊娠率为88.64%。剔除术后总妊娠率为86.84%,其中行单侧剔除术后妊娠率为85.71%,双侧肿瘤剔除术后为90%;一侧附件切除术和一侧附件切除加对侧卵巢肿瘤剔除术后的妊娠率为100%。结论卵巢肿瘤剔除术是治疗年轻女性良性卵巢肿瘤的适当、有效的方法。在本组研究中,其术后复发率为4.23%,与附件切除术后无显著性差异。月经异常率为8.45%,优于附件切除术。对有生育要求的良性卵巢肿瘤患者行肿瘤剔除术后总妊娠率达86.84%。Objectives In order to have a complete analysis of the effectiveness of conservative laparotomy surgery on benign ovarian tumors, especially on the postoperative recurrence, survival and pregnancy rate in young patients, and therefore to help clinicians to decide the treatment and choose the optimal type of surgery, methods We retrospectively investigated the clinical information of patients with benign ovarian tumors during Jan Ist 1994 through Dec 31st 2001. A total of 149 patients were included in this study. Results One hundred and eighteen patients were successfully followed up. Four types of conservative surgical procedure were performed： unilateral adnexectomy （UA）, UA with eontralateral cystectomy （UA＋CC）, unilateral cystectomy （UC）, and bilateral cystectomy （BC）.There were no significant influence on the menstruation and pregnancy after surgery （P〉0.05）. Statistics show no significant difference in the total recurrence rate between three groups： UC, BC group, UA and UA＋UC group （P=0. 319）. The menstruation abnormality is more common in UA , UA＋UC or BC group than UC group P〈 0.05. Also the pregnancy rate is not different in three groups （P〉 0. 05）.Conclusions Cystectomy is an appropriate and effective approach to treat benign ovarian tumors in young women.

关 键 词：卵巢肿瘤 手术治疗 

分 类 号：R737.31[医药卫生—肿瘤]