围绝经期及绝经后妇女附件包块126例临床分析  

Clinical Analysis Of 126 Perimenopausal And Postmenopausal Women With Adnexal Masses.

作　　者：黄峥[1] 唐家龄[1] 王一斌[1] 

机构地区：[1]广州市妇婴医院妇产科,广东广州510180

出　　处：《海南医学》2004年第2期25-26,28,共3页Hainan Medical Journal

摘　　要：目的 探讨围绝经期及绝经后妇女附件包块的监测及其恶性的风险。方法 回顾性分析126例围绝经期及绝经后妇女附件包块的临床资料:结果126例中114例接受手术治疗,其中卵巢恶性肿瘤11例,占9.6％,以上皮来源为主(10例,占90.9％);103例为附件良性病变,占90.4％,其中卵巢肿瘤61例(59.2％),非赘生性囊肿42例(40_8％)。12例未行手术治疗,其中6例经随访2—6月附件包块消失,6例包块无明显变化仍继续随访,未发现恶变倾向。恶性肿瘤包块多为双侧混合性.直径>10cm,伴腹水及CA125升高,良性包块常为单侧单房囊性,直径<10cm,无腹水及CA125升高,两者有极显著性差异(P<0.01)。结论 围绝经期及绝经后妇女一侧附件5cm以下单房囊肿恶性风险低,可以定期随访,不必急于手术;而10cm以上双侧附件混合性包块,特别是伴乳头或实性区域,有增厚分隔,合并CA125升高及腹水者恶性风险高,应积极手术治疗。Objective To evaluate the surveillence and risk of malignancy in perimenopausal and postmenopausal women with adnexal masses.Methods The clinical data of 126 perimenopausal and postmenopausal patients with adnexal masses from January 1999 to January 2003 were analyzed retrospectively in our hospital.Results 114 of 126 patients underwent operative intervention.11 (9.6%) in this group had ovarian malignant tumors and 103 (90.4%) had adnexal benign of epithelial origin.Of the benign cases, 61 (59.2% ) had ovarian tumors and 42 (40.8%) were nonneoplastic adnexal cysts. 12 of 126 patients with adnexal cysts were followed at 3-to 6-month intervals without surgery,and 6 of these cysts resolved spontaneously within 2-6 months,the other 6 patients with persisting cysts elected to be followed rather than undergoing surgery.No patient has developed ovarian cancer.Malignant masses were significantly different from benign lesions regarding the size>10cm in diameter (P<0.01) ,complex components (P< 0.01) and bilateral masses (P <0.01) .Conclusions Unilateral adnexal unilocular cysts <5cm in diameter in perimenopausal and postmenopausal women are associated with minimal risk for ovarian cancer and can be followed at 3-to 6-month intervals without surgery.In contrast, bilateral adnexal complex masses with internal papillary projections,solid areas or septal abnormalities, particularly with elevated CA 125 levels and ascites are associated with a significant risk for malignancy and should be removed surgically.

关 键 词：围绝经期 绝经后 妇女 附件包块 手术治疗 卵巢肿瘤 

分 类 号：R737.31[医药卫生—肿瘤]