女童卵巢囊肿蒂扭转9例误诊分析 _临床医学论文.docVIP

女童卵巢囊肿蒂扭转9例误诊分析 _临床医学论文 女童卵巢囊肿蒂扭转9例误诊分析 _临床医学论文 【摘要】 目的 探讨女童卵巢囊肿蒂扭转的临床特点，诊断及治疗。方法 对2003年1月～2009年10月洛阳市妇女儿童医疗保健中心收治的女童卵巢囊肿蒂扭转的临床资料进行回顾性分析。结果 患儿平均年龄9岁，右侧7例，左侧2例。运动中或运动后下腹痛伴恶心、呕吐为其主要临床表现。9例均经手术确诊，7例误诊为阑尾炎，1例误诊为泌尿系结石，1例剖腹探查术中发现。初诊B超检查0例，术前B超检查均示盆腔有包块及盆腹腔少量积液。7例行右附件切除，2例保留卵巢成功。 结论 卵巢囊肿蒂扭转是外科急腹症，需要早期诊断和治疗以保护和挽救女童的卵巢功能。对伴有急性下腹痛的女童，无论腹痛程度如何，诊断时一定要考虑到卵巢囊肿蒂扭转，行急诊超声检查。急诊手术治疗并尽可能的保护女童的卵巢功能。 【关键词】 蒂扭转 卵巢囊肿 女童 误诊 【Abstract】 Objective To investigate the clinical features, diagnostic criteria, treatment methods of torsion of pedicle of ovary cysts in children. Methods 9 cases of torsion of pedicle of ovary cysts in children treated in our hospital from 2003 to 2009 were retrospectively analyzed. Result The average age is 9 years. This pathology was located in 7 cases on the right side and in 2 cases on the left side. The main clinical presentation was lower abdominal pains and vomiting in or after exercises. 9 cases were all confirmed by surgery, 7 cases and 2 cases were misdiagnosed appendicitis and urolithiasis respectively, 1 case was diagnosed in exporatory laparotomy. No case was performed pelvic ultrosonography in preliminary diagnosis, but preoperative examination discovered pelvic masses and small amounts of fluidify. 7 young girls had underwent a annexectomy, only 2 cases succeeded in ovary preservation. Conclusion As a surgical emergency, it is necessary for torsion of pedicle of ovary cysts to be early diagnosed and treated in order to protect and retrieve the function of children’s ovary. We must consider torsion of pedicle of ovary cysts to children with acute lower abdominal pains, regardless of degree, and perform pelvic ultrosonography. Emergency operation must be done and protect the children’s ovary function as possible. 【Key words】 Torsion of pedicle ovary cysts children Misdiagnose 女童卵巢囊肿蒂扭转发病率低，临床表现不典型，术前误诊率极高，文献报道相对少见。为探讨此病儿童期的临床表现特点及诊断治疗，本文对洛阳市妇女儿童医疗保健中心收治的9例女童卵巢囊肿蒂扭转病例做一回顾性分析，以期提高认识： 1 材料与方法 复习2003年1月～2009年10月洛阳市妇女儿童医疗保健中心收治并经手术确诊的女童卵巢囊肿蒂扭转病例9例的临床资料，总结其