胎儿/新生儿卵巢囊肿的转归及治疗:35例临床分析  

Prognosis and treatment of fetal/neonatal ovarian cysts: clinical analysis of 35 cases

作　　者：方元龙 葛午平[1] 张燕 周佳亮[1] 黄蓉 汪青园 田松[1] 原丽科 朱小春[1] Fang Yuanlong;Ge Wuping;Zhang Yan;Zhou Jialiang;Huang Rong;Wang Qingyuan;Tian Song;Yuan Like;Zhu Xiaochun(Department of Neonatal Surgery,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Gynecology,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院新生儿外科,广州511400 [2]广东省妇幼保健院妇科,广州511400

出　　处：《中华围产医学杂志》2021年第9期671-681,共11页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨胎儿/新生儿卵巢囊肿的转归及治疗经验。方法回顾性纳入2014年6月至2019年12月广东省妇幼保健院收治的35例卵巢囊肿患儿(囊肿38个),收集患儿产前、生后卵巢囊肿大小、超声特征、术中情况及病理等临床资料。根据产前首次检出囊肿时的超声特征分为简单型囊肿组(25个)和复杂型囊肿组(13个),采用两独立样本t检验和Fisher精确概率法比较2组患儿的囊肿特征。总结囊肿的转归及治疗经验。结果(1)产前首次超声检出囊肿时,复杂型囊肿的术中扭转率高于简单型囊肿[10/13与32%(8/25),Fisher精确概率法,P<0.05]。(2)产前首次超声检出简单型囊肿25个,32%(8/25)最终转化为复杂型囊肿。这8个囊肿中5个囊肿最大径>4 cm。(3)生后超声发现1个简单型囊肿自然消退,剩余37个囊肿中简单型囊肿16个,复杂型囊肿21个;复杂型囊肿中,90%(19/21)在宫内即是复杂型囊肿。(4)生后超声发现21个复杂型囊肿,19个手术,另外2个囊肿(最大径<3 cm)保守观察并于1年内自然消退;术中发现81%(17/21)的复杂型囊肿有扭转,24%(5/21)出现卵巢丢失。结论简单型囊肿可转化为复杂型囊肿,尤其最大径>4 cm时;超声提示为复杂型的卵巢囊肿更容易发生扭转,建议生后积极手术治疗.Objective To explore the prognosis and treatment experience of fetal/neonatal ovarian cyst.Methods Clinical data of 35 cases of fetal/neonatal ovarian cyst(38 ovarian cysts)admitted to Guangdong Women and Children Hospital from June 2014 to December 2019 were retrospectively collected,including the cyst size before and after birth,ultrasonic features,intraoperative conditions,and pathology.According to the ultrasonic features at the first prenatal detection,the ovarian cysts were divided into two groups:simple cyst group(25 cysts)and complex cyst group(13 cysts).Two independent samples t-test and Fisher exact test were used to compare the characteristics of cysts between the two groups.The outcomes and treatment experience were summarized.Results(1)The ratio of intraoperative torsion in the complex cysts group was higher than that in the simple cysts group[10/13 vs 32%(8/25),Fisher exact test,P<0.05].(2)Twenty-five simple cysts were found on the first prenatal ultrasound scan,and 32%(8/25)of them eventually transformed into complex cysts.Among these eight cysts,the maximum diameter of five cysts was>4 cm before the transformation.(3)Postnatal ultrasound found one cyst regressed spontaneously and among the remaining 37 cysts,simple and complex type cysts were accounted for 16 and 21,respectively.Among the complex type cysts,90%(19/21)were consistent with prenatal ultrasound.(4)Out of the 21 complicated cysts,19 were surgically removed;the remaining two cysts(maximum diameter<3 cm)were observed conservatively and disappeared spontaneously within one year.During the operation,81%(17/21)of the complicated cysts were found with torsion and 24%(5/21)with ovarian loss.Conclusions Simple cysts can transform into complex cysts,especially the biggest diameter>4 cm.Complex fetal/neonatal ovarian cysts indicated by ultrasonography were more prone to torsion,which required postnatal operation.

关 键 词：卵巢囊肿 外科手术 治疗结果 胎儿 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]