儿童卵巢黄体破裂误诊原因探讨  

Causes of Misdiagnosis of Ovarian Corpus Luteum Rupture in Children

作　　者：丁庆光[1] 庄博[1] DING Qingguang;ZHUANG Bo(Departments of Pediatric Surgery,the First People's Hospital of Jining,Jining,Shandong 272000,China)

机构地区：[1]济宁市第一人民医院小儿外科,山东济宁272000

出　　处：《临床误诊误治》2025年第7期20-24,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的分析青春期儿童卵巢黄体破裂的误诊原因及预防误诊的措施。方法分析2023年1月至2024年11月被误诊的4例卵巢黄体破裂患儿的临床资料,从发病时间、诱因、临床表现、辅助检查等方面分析卵巢黄体破裂被误诊误治的原因,总结经验并提出相应的预防措施。结果4例患儿均以急腹症入院,年龄均为12岁,2例发生在末次月经后第4周,1例发病前有剧烈运动的诱因,3例右下腹疼痛,1例左下腹疼痛。4例术前血常规、C反应蛋白、降钙素原、凝血酶原时间、纤维蛋白原等相关辅助检查未见明显异常,2例行超声检查见附件区囊实性包块。3例行CT检查示阑尾腔内粪石并阑尾炎可能,附件区囊实性包块。3例误诊为急性阑尾炎,1例误诊为卵巢囊肿蒂扭转。4例患儿均接受腹腔镜手术治疗,术中探查均确诊为卵巢黄体破裂。误诊时间3~6 h。确诊后均行卵巢黄体囊肿剔除卵巢修补术,手术顺利,术后恢复良好。结论卵巢黄体破裂是导致青春期儿童急腹症的一个少见病因,儿科医师应该提高对该病的认识,避免儿童卵巢黄体破裂被误诊误治。Objective To analyze the causes of misdiagnosis of ovarian corpus luteum rupture in adolescents and the measures to prevent misdiagnosis.Methods From January 2023 to November 2024,the clinical data of 4 patients ovarian corpus luteum rupture misdiagnosed in children were analyzed.The causes of misdiagnosis and mistreatment of ovarian corpus luteum rupture were analyzed from the aspects of onset time,inducing factors,clinical manifestations,auxiliary examination,and the corresponding preventive measures were proposed.Results All the 4 children aged 12 years were admitted to the hospital with acute abdomen.Two patients had the first onset in the fourth week after the last menstrual period,1 patient had strenuous exercise before the onset,3 patients had right lower abdominal pain,and 1 patient had left lower abdominal pain.There were no obvious abnormalities in blood routine,C⁃reactive protein,procalcitonin,prothrombin time,fibrinogen and oth⁃er related auxiliary examinations in 4 patients before operation.Two patients underwent ultrasound examination which showed cystic and solid masses in the adnexal region.CT examination showed a fecal stone in the appendix cavity,possible appendici⁃tis,and a cystic⁃solid mass in the adductor region.Three patients were misdiagnosed with acute appendicitis,and 1 patient with torsion of ovarian cyst pedicle.All the 4 patients underwent laparoscopic surgery and were diagnosed as ovarian corpus lu⁃teum rupture during operation.The misdiagnosis lasted 3⁃6 h.After diagnosis,all patients underwent ovarian corpus luteum cyst removal and ovarian repair.The operation was successful and the postoperative recovery was good.Conclusion Rupture of ovarian corpus luteum is a rare cause of acute abdomen in adolescents.Pediatricians should improve the understanding of this disease to avoid misdiagnosis and mistreatment of rupture of ovarian corpus luteum in children.

关 键 词：卵巢黄体破裂 儿童 误诊 卵巢囊肿蒂扭转 急性阑尾炎 腹痛 腹腔镜检查 急腹症 

分 类 号：R711.75[医药卫生—妇产科学]