妊娠合并卵巢囊肿蒂扭转治疗的新进展  

Recent trend in treatment of adnexal torsion in pregnancy

作　　者：张诚燕[1] 周莉[1] 

机构地区：[1]首都医科大学附属北京妇产医院产科,北京100026

出　　处：《中国医药科学》2016年第18期37-39,共3页China Medicine And Pharmacy

摘　　要：卵巢囊肿蒂扭转是常见的妇科急腹症,妊娠期特殊的生理变化使其更易发生。妊娠合并卵巢囊肿蒂扭转最常见的症状包括腹痛、恶心呕吐腹泻、发热、阴道流血及不规律宫缩,体征不典型。超声有助于明确诊断并除外其他急腹症。C反应蛋白及凝血功能D-二聚体升高提示卵巢囊肿蒂扭转。大部分患者需急诊手术治疗。可通过高位结扎卵巢动、静脉,其后行卵巢囊肿切除术,尽量保留卵巢。保留的卵巢可恢复正常功能并排卵。腹腔镜手术在孕期安全,且术后并发症如切口愈合不良、盆腹腔粘连、血栓性疾病等发生率低,手术时间、术中出血量、术后排气时间、术后住院天数均明显优于开腹。围手术期应给予抑制宫缩治疗。Adnexal torsion is a gynecologic emergency. And it is more common during pregnancy period due to the physiological changes. The patients always suffer from pelvic pain, nausea, vomiting, diarrhea, fever, vaginal bleeding or erratically uterine contraction, but with untypical sign. Ultrasound is paramount importance in differential diagnosis. Elevated CRP and serum D-dimer levels are related to adnexal torsion. Most patients need emergency surgery. Ovary could be positively retained by ovarioeysteetomy, in front of which the artery and vein of ovary should be ligated in advance. The reserved ovaries remain normal functions,and ovulation can be recovered.Laparoscopy has been successfully used in pregnancy, and it is safe with less complications as poor wound healing, pelvic adhesion, thromboembolism, etc.The benefits of laparoscopic surgery are respect to lesser operation time, decreased blood loss, earlier ambulation and reduced length of hospital stay outweigh those of traditional laparotomy. Anti-uterine contraction should be used in perioperative period.

关 键 词：妊娠 卵巢囊肿蒂扭转 治疗 综述 

分 类 号：R713.6[医药卫生—妇产科学]