41例卵巢肿瘤蒂扭转临床诊治探讨.docVIP

精品论文 参考文献 41例卵巢肿瘤蒂扭转临床诊治探讨 孙健(丹东市妇女儿童医院妇产科 118000) 　　【摘要】目的：探讨卵巢肿瘤蒂扭转临床诊治要点。方法：收集本院2010年~2013年卵巢肿瘤蒂扭41例临床资料进行回顾性分析，探讨疾病诊断、鉴别诊断及选择手术治疗时机和方法。结果：根据突发下腹痛，伴或不伴恶心呕吐，双合诊可及宫旁压痛的肿块，以蒂部最明显，盆腔彩超证实有附件区存在，术前确诊比率是22%, 术前可疑诊断比率48.8%,误诊比率29.3%,。5例行卵巢肿瘤核除术，36例行患侧附件切除术。结论：结合临床表现，严格鉴别诊断后，只要拟诊卵巢肿瘤蒂扭转，应急诊手术治疗，备术中冰冻。术式除明确卵巢肿瘤已较窄性全部坏死外，均可行卵巢肿瘤核除术。 　　【关键词】卵巢肿瘤蒂扭转 ； 诊断 ； 急诊手术 　　【中图分类号】RA 【文献标识码】A 【文章编号】1672-5085（2013）36-0032-02 　　The clinical diagnosis and treatment for ovarian tumor torsion: a study of 41 cases 　　 Sun Jiandan 　　Departmant of Obstetrics and Gynecology,Dandong Women and children Hospital,Dandong118000,China 　　【Abstract】 Objective To investigate the clinical characteristics of ovarian tumor torsion. Methods: 41 patients treated in our hospital between 2010 and 2013 were analyzed retrospectively to discuss how to diagnose and distinguish the disease and when to make surgical operations. Results The preoperative diagnosis was made according to whether there present the lower abdomen pain, the symptoms of nausea and vomiting, the touch of ache-masses near the uterine and the pelvic-ultrasound confirmed tumor at fallopian and ovarian area. The preoperative diagnosis rate was 22%, the preoperative suspicious diagnosis rate 48.8%, the misdiagnosis rate 29.3%. 5 patients underwent tumorectomy, 36 patients underwent unilateral salpingo-oophorectomy. Conclusion Emergency operation should be made if ovarian tumor torsion was confirmed through clinical manifestation while excluding other possible diagnosis. During operation the frozen specimen for pathological examination is recommended. Tumorectomy could be conducted if there is no necrosis in ovarian tumor. 　　【Key words】 ovarian tumor torsion; diagnosis; emergency surgery 　　卵巢肿瘤蒂扭转是第五位妇产科急症，一经确诊应尽快手术治疗。临床工作中常遇到诊断依据不充分，临床可疑卵巢肿瘤蒂扭转病例和腹痛暂缓解病例，暂保守治疗，待进一步明确诊断后手术治疗，或以卵巢肿瘤（扭转？）为手术指证择期手术治疗，多数病例术中证实患侧卵巢肿瘤扭转多已坏死发黑，无法保留卵巢功能，为探讨如何避免首诊治疗手术时机滞后，争取更多保留卵巢功能机会，现收集我院41例卵巢肿瘤蒂扭转临床资料，回顾总结报告如下。 　　1