100例儿童与青少年卵巢畸胎瘤临床诊治分析  

Clinical diagnosis and treatment analysis of ovarian teratomas in 100 children and adolescents

作　　者：黄艳[1] 黄禾[1] 尹玲[1] 周应芳[1] 李克敏[1] HUANG Yan;HUANG He;YIN Ling;ZHOU Yingfang;LI Kemin(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing,100034,China)

机构地区：[1]北京大学第一医院妇产科

出　　处：《中国妇产科临床杂志》2025年第2期117-120,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：北京大学第一医院青年培育基金(23CZ02010505-4805563)。

摘　　要：目的探讨儿童与青少年卵巢畸胎瘤临床特点和治疗效果。方法收集2010年1月至2022年5月北京大学第一医院妇产科住院手术治疗、年龄18岁以下100例卵巢畸胎瘤患者的资料进行回顾性分析。结果100例卵巢畸胎瘤占同期住院儿童与青少年卵巢肿瘤的46.3%(100/216),其中97%(97/100)为成熟性畸胎瘤,3%(3/100)为Ⅰ期未成熟畸胎瘤;13%(13/100)发生附件扭转。术前影像学诊断畸胎瘤的符合率中,超声检查为60%(60/100),CT为90%(18/20),MRI为58.3%(7/12),超声诊断附件扭转的准确率为46.2%(6/13)。100例患者均手术治疗,其中87例腹腔镜、13例开腹手术;开腹组较腹腔镜组肿瘤直径更大(P<0.001)、手术时间(P=0.009)及住院时间(P<0.001)长,术后复发风险无差异(P=0.438)。术后随访1~13年,5.3%(4/76)患儿复发,其中初治时为双侧畸胎瘤复发风险高(P=0.040)。结论儿童与青少年常见的卵巢畸胎瘤发生附件扭转的风险较高,腹腔镜卵巢肿物切除术为首选治疗方法。Objective To analyzes the clinical characteristics and treatment outcomes of ovarian teratomas in 100 children and adolescent patients.Methods The data of 100 patients under 18 years of age who underwent surgical treatment for ovarian teratoma in the Department of Obstetrics and Gynecology,Peking University First Hospital from January 2010 to May 2022 were collected and analyzed.Results The 100 cases of ovarian teratomas constituted for 46.3%(100/216)of all ovarian tumors in hospitalized children and adolescents during the study period.Among these,97%(97/100)were mature teratomas,and 3%(3/100)were StageⅠimmature teratomas.Adnexal torsion was observed in 13%(13/100)cases.The preoperative diagnostic accuracy of imaging modalities for teratomas was 60%(60/100)for ultrasound,90%(18/20)for CT,and 58.3%(7/12)for MRI.Ultrasound detected adnexal torsion with 46.2%(6/13)accuracy.All 100 patients received surgical treatment,including 87 cases by laparoscopy and 13 cases by laparotomy.The tumor diameter in the laparotomy group was larger than that in the laparoscopy group(P<0.001),and the operation times(P=0.009),hospital stays(P<0.001)were longer.There was no significant difference in the risk of postoperative recurrence between the two surgical approaches(P=0.438).During a follow-up period ranging from 1 to 13 years,5.3%(4/76)of patients experienced recurrence,with initial bilateral teratomas being associated with a higher risk of recurrence(P=0.040).Conclusions Ovarian teratomas,which are common in children and adolescents,have a relatively high risk of adnexal torsion.Laparoscopic ovarian tumor resection is the preferred treatment method.

关 键 词：儿童与青少年妇科 卵巢畸胎瘤 腹腔镜 复发 

分 类 号：R73[医药卫生—肿瘤]