卵巢重度水肿的诊断学特征分析  

Diagnostic characteristics of massive ovarian edema

作　　者：柳发勇 杨阳[2] 张功学[2] 邱珊 齐峰[2] 常欢 Liu Fayong;Yang Yang;Zhang Gongxue;Qiu Shan;Qi Feng;Chang Huan(Department of Gynecology,the First People′s Hospital of Zaoyang,Zaoyang 441200,China;Department of Pathology,the First People′s Hospital of Zaoyang,Zaoyang 441200,China;Operating Room,the First People′s Hospital of Zaoyang,Zaoyang 441200,China)

机构地区：[1]枣阳市第一人民医院妇科,441200 [2]枣阳市第一人民医院病理科,441200 [3]枣阳市第一人民医院手术室,441200

出　　处：《中华诊断学电子杂志》2023年第2期128-132,共5页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：襄阳市科技向医疗卫生领域科技计划项目(2022YL49A);枣阳市科学技术和经济信息化局卫生项目(202107)。

摘　　要：目的探讨卵巢重度水肿的诊断学特征。方法回顾性分析2017年1月至2022年1月枣阳市第一人民医院妇科收治的经病理确诊的4例卵巢重度水肿患者的临床资料,并进行文献复习。结果4例患者年龄16~28岁,均有不同程度下腹盆腔痛;妇科超声提示附件区或盆腔低回声包块;3例患者妇科肿瘤标记物检查正常;2例行生殖激素检测,1例诊断为多囊卵巢综合征;4例患者行腹腔镜/剖腹探查术,术中见包块为卵巢增大、肿胀伴扭转,颜色呈瓷白色、淡红色、暗红色不等,卵巢质地坚韧有弹性,切面可见水肿液或血性液体渗出,术中快速冰冻病理检查提示良性病变,术后常规病理检查见不同发育阶段卵泡,水肿区血管、淋巴管显露。结论卵巢重度水肿患者年轻,绝大部分与卵巢扭转相关,结合病史、术前检查,快速冰冻病理检查指导手术方式意义重大。Objective To investigate the diagnostic features of massive ovarian edema(MOE).Methods The clinical data of 4 patients with MOE were retrospectively analyzed,which were diagnosed by pathological diagnosis in the First People′s Hospital of Zaoyang from January 2017 to January 2022.The corresponding literatures were reviewed,simultaneously.Results Four patients,16 to 28 years old,had varying degrees of lower abdominal pelvic pain.All patients underwent ultrasound examination,and gynecological ultrasound showed hypoechoic mass in the annex area or lower abdominal pelvic cavity.Gynecological tumor markers were normal in 3 cases.Two cases underwent reproductive hormone testing,and 1 case was diagnosed with polycystic ovary syndrome.Four patients underwent laparoscopy or laparotomy procedure.The mass was seen as enlarged and swollen ovary with torsion during operation,and the color was porcelain white,pale red,or dark red,the ovary was tough and elastic,and edema fluid or bloody fluid exudation could be seen on the section.Benign lesions were found through intraoperative frozen section examination.Follicles at different developmental stages were found in the postoperative routine pathological examination,and blood vessels and lymphatic vessels were exposed in the edema area.Conclusions The patients with MOE are young and related to ovarian torsion.Combination of the medical history,preoperative examination,and intraoperative frozen section examination plays an important role in guiding the surgical procedure.

关 键 词：卵巢重度水肿 病理学 临床 疾病特征 诊断 

分 类 号：R711.75[医药卫生—妇产科学]