妊娠合并卵巢肿瘤或卵巢瘤样病变对妊娠结局的影响  

Effect on Pregnancy Outcome by Pregnancy Associated with Ovarian Tumor and Ovarian Tumor like Condition

作　　者：于月新 李巨 陈红 陈佳 王列 

机构地区：[1]解放军202医院妇产科,沈阳110812

出　　处：《解放军医药杂志》2012年第11期14-16,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：辽宁省自然科学基金(201102233)

摘　　要：目的探讨妊娠合并卵巢肿瘤或卵巢瘤样病变的临床特征、处理方法及对妊娠结局的影响。方法对我院2003年1月—2009年12月收治的248例经手术和病理诊断为妊娠合并卵巢肿瘤或瘤样病变患者的临床资料进行回顾性分析。结果我院2003—2009年妊娠合并卵巢肿瘤及卵巢瘤样病变发病率为0.49%(248/50 652)。其中妊娠合并卵巢良性肿瘤131例(52.82%),以成熟囊性畸胎瘤多见;合并瘤样病变113例(45.56%),以子宫内膜异位囊肿多见;合并恶性肿瘤4例(1.61%)。经B超检查发现184例(74.19%),其中孕早期135例,孕中期47例,孕晚期2例;经盆腔检查发现8例;余56例于剖宫产术中发现。孕早期手术31例;孕中期有72例手术切除肿物后予保胎治疗;孕晚期有113例在剖宫产的同时行肿物切除术,32例经阴道分娩后择期开腹或腹腔镜下切除卵巢肿瘤。14例行急诊手术,其中发生卵巢囊肿蒂扭转9例,发生卵巢囊肿破裂5例。本组足月产196例,早产19例,其中新生儿死亡3例,流产33例。结论妊娠合并卵巢肿瘤或瘤样病变多无临床症状,易被忽略,盆腔检查及超声检查对其诊断和监测具有重要意义,治疗以肿瘤切除术为主,孕中期行手术干预是安全可行的。Objective To explore effect on clinical characteristics, management and pregnancy outcome of pregnancy associated with ovarian tumor and ovarian tumor like condition. Methods Clinical data of 248 patients with pregnancy associated with ovarian tumor and ovarian tumor like condition dignosed by operation and pathology during January 2003 and December 2009 in our hospital was retrospectively analyzed. Results The incidence rate of pregnancy associated with ovarian tumor and ovarian tumor like condition in our hospital during 2003-2009 was 0.49% （248/50 652） , which included 131 patients with pregnancy associated with benign ovarian tumor （52.82%） and there were mostly ovarian mature teratomas; 113 patients with combination of tumor-like lesion （45.56%） which mostly were endometrial cyst and 4 patients （ 1.61% ） with combination of malignant tumor. 184 patients （74.19%） were diagnosed by uhrasonogra- phy which included 135 patients in early gestation, 47 patients in mid-gestation and 2 patients in late-gestation; 8 patients were diagnosed by pelvioscopy and other 56 patients were diagnosed during cesarean section. 31 patients were performed operation in early gestation; 72 patients in mid-gestation were treated with surgical ablation and tocolyis; in late-gestation 113 patients were performed ablative surgery during uterine-incision delivery and 32 patients were performed ectomy by operation or under laparoscopes after vaginal delivery. 14 patients were performed emergency operation, among which 9 had torsion and 5 had ruptured ovarian cyst. There were 196 patients with term birth, 19 patients with premature birth, 3 cases with neonatal death and 33 cases with miscarriage. Conclusion Pregnancy associated with ovarian tumor and ovarian tumor like condition shows no clinical characteristics and easily been ignored. Pelvioscopy and ultrasonography are very useful for diagnosis. Suitable surgery intervention during second trimester might be safe.

关 键 词：妊娠 卵巢肿瘤 卵巢瘤样病变 妊娠结局 

分 类 号：R714.259[医药卫生—妇产科学]