产前诊断胎儿卵巢囊肿的系统管理与生后早期手术治疗  

Prenatally diagnosis, systematic management and early surgical treatment of neonatal ovarian cysts

作　　者：冯翠竹[1] 马继东[1] 王莹[1] 马丽霜[1] 张悦[1] 叶蓁蓁[1] 

机构地区：[1]首都儿科研究所附属儿童医院小儿外科,北京100020

出　　处：《中国新生儿科杂志》2013年第4期238-240,共3页Chinese Journal of Neonatology

摘　　要：目的探讨产前诊断胎儿卵巢囊肿的系统管理与生后早期手术治疗。方法选择2002年9月至2012年9月北京市三级医院产前超声检查拟诊为卵巢囊肿,并在本院小儿外科接受产前咨询、新生儿或小婴儿期进行手术治疗的病例。小儿外科医生在咨询中对胎儿准父母提出病变监测、出生后检查及外科治疗计划。手术指征:囊肿体积巨大,复杂型囊肿,以及不排除卵巢畸胎瘤者。结果接受产前咨询共45例,其中15例在出生后经手术证实并治疗。手术年龄:≤7天3例,8～30天9例,1～5个月3例。术中情况:5例巨大单纯性囊肿在未发生扭转与出血的情况下手术。10例超声检查为囊壁增厚、囊内混合强回声的复杂型囊肿,手术证实囊内充盈稠厚血性液体或坏死组织,部分伴囊壁坏死,未穿孔。手术以切除囊性病变而尽可能保留卵巢、输卵管等附件组织为基本原则。结论对于产前诊断的胎儿卵巢囊肿实施系统化管理,有利于患儿安全度过围产期,及时接受必要的手术治疗,最大限度地避免或减少卵巢囊肿扭转、出血、囊壁坏死等严重并发症的发生,改善预后。Objective To study the systematic management and early surgical treatment of prenatally diagnosed ovarian cysts in neonates. Methods From September 2002 to September 2012, cases of suspected ovarian cysts detected prenatally using ultrasound were included from 3 tertiary hospitals in Beijing. The prospective parents were counseled with the pediatric surgeons about the plan of management after birth. Results Out of 45 prenatally consulted cases, 15 were confirmed after birth and performed operation. 3 patients had operation in ≤ 7 days after birth, 9 patients in 8 -30 days and 3 cases in 1 -5 months. Surgical findings included： 5 cases with big simple cysts without torsion and hemorrhage. 10 complicated cases with thickened wall or mixed hypersonic echo in ultrasound showed thickened bloody fluid or necrotic tissue, part of the wall were necrotic without perforation. The principle of surgery was to remove the cysts completely while keeping the ovarian with fallopian tubes and other accessories intact. Conclusions Systematic management and early surgical treatment after birth in patients with prenatally diagnosed ovarian cysts were beneficial to the babies throughout the perinatal period and could improve the prognosis.

关 键 词：卵巢囊肿 产前诊断 超声检查 手术治疗 

分 类 号：R714.5[医药卫生—妇产科学]