全子宫切除术后卵巢肿物特点及腹腔镜下手术技巧研究  

Characteristics of ovarian neoplasm after hysterectomy and operation skill under laparoscope

作　　者：马俊英[1] 赵焕焕[1] 许磊婵 孙江慧[1] 刘雪洁[1] 李利[1] 

机构地区：[1]河北医科大学第四医院妇产科,河北石家庄050011

出　　处：《中国实用妇科与产科杂志》2017年第3期283-287,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：河北省医学科学研究重点课题计划指令性课题项目(ZD20140419)

摘　　要：目的探讨因良性疾病或癌前病变行全子宫切除术后卵巢肿物的特点,并总结腹腔镜下手术治疗的技巧。方法收集2005年8月至2013年8月于河北医科大学第四医院因全子宫切除术后盆腔肿物接受手术治疗的132例患者临床资料,对卵巢肿物的良恶性、患者发病年龄以及再次手术与初次手术时间间隔进行分析。结果 132例患者中,卵巢良性肿物94例,占71.21%,其中以卵巢单纯囊肿、卵巢巧克力囊肿多见;恶性肿瘤38例,占28.79%,以卵巢浆液性囊腺癌多见。全子宫切除术后卵巢肿瘤好发年龄为>45~55岁。全子宫切除术后卵巢良性肿物及恶性肿瘤多发生在术后10年内。腹腔镜下手术时,宜注意穿刺孔的选择、粘连的分解以及输尿管位置的改变。结论全子宫切除术后卵巢肿物以良性居多,可以选择腹腔镜探查。手术时套管穿刺位置选择宜远离原切口瘢痕,分离粘连时注意输尿管位置的改变,可以有效地降低腹腔镜转开腹手术率及手术损伤的机会。Objective To explore the characteristics of ovarian neoplasm after hysterectomy because of benign diseases or precancerous lesions,and to conclude the operation skills under laparoscope.Methods The data of 132 patients with pelvic neoplasm after hysterectomy were collected,who were given operation in the Fourth Hospital of Hebei Medical University from August 2005 to August 2013,and the nature of neoplasm,onset age,and the time interval between first operation and a second one were analyzed.Results There were 94 patients with benign ovarian neoplasm,which occupied 71.21% of 132 cases,mostly being ovarian simple cysts and chocolate cysts.There were 38 malignant ovarian tumor patients,which occupied 28.79%,mostly being ovarian serous cyst adenocarcinoma.The ovarian neoplasm after hysterectomy often occurred at age 〉45-55.The occurrence rate of benign ovarian neoplasm and malignant tumors was high after hysterectomy in 10 years.It was important to be careful of puncture hole choices,adhesion release and the location change of urinary tubes while doing laparoscopic operations.Conclusion It＇s appropriate to choose laparoscopic exploration since most of ovarian neoplasms after hysterectomy are benign. It＇s better to choose the location of pork card away from the old operation scar and be careful of the ureter location change while performing the separation of adhesion,which is an effective way to reduce the chances of laparoscopic operations turning to open ones and operation hurts.

关 键 词：卵巢肿物 全子宫切除术 腹腔镜手术 

分 类 号：R713.42[医药卫生—妇产科学]