本文選題：青春期 + 卵巢腫瘤��； 參考：《寧夏醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：分析總結(jié)青春期卵巢腫瘤的臨床特點、診斷及治療,為其提高其早期診斷率，改善預(yù)后提供依據(jù)。 方法：回顧性分析我院2007年1月至2012年11月間收治的105例10-19歲卵巢腫瘤患者的臨床資料，分析其發(fā)病情況、臨床特點、病理類型、輔助檢查、治療方法及隨訪情況。 結(jié)果：青春期卵巢腫瘤多以腹痛就診共51例，占48.57%，，27例無任何癥狀僅體檢發(fā)現(xiàn)，占25.71%。術(shù)前B超提示卵巢腫瘤直徑大于10cm時惡性及交界性腫瘤的發(fā)生率增加，應(yīng)用超聲圖像評分系統(tǒng)進行評分，在術(shù)前判斷卵巢腫瘤性質(zhì)上有明顯作用。105例青春期卵巢腫瘤中，良性腫瘤93例占88.57%、惡性腫瘤8例占7.61%、交界性腫瘤4例占3.80%。組織學(xué)分型中，生殖細胞腫瘤51例占48.57%、瘤樣病變27例占25.71%、上皮性腫瘤25例占23.80%、性索間質(zhì)細胞腫瘤1例占0.95%。105例患者均行手術(shù)治療且術(shù)后病理證實，術(shù)中冰凍與術(shù)后病檢符合率為94.28%。良性腫瘤中88例行卵巢囊腫剝除術(shù)，5例行患側(cè)附件切除術(shù)；4例交界性腫瘤中3例行卵巢腫瘤剝除，1例行行子宮+右附件+大網(wǎng)膜+闌尾切除術(shù)。8例惡性腫瘤均行保留生育功能的手術(shù)，其中6例術(shù)后給予PVB或PEB化療。 結(jié)論：青春期卵巢腫瘤就診時主要以腹痛為主，其次為體檢發(fā)現(xiàn)，應(yīng)重視對青春期女性的婦科普查。B超有助于術(shù)前判斷卵巢腫瘤的性質(zhì)應(yīng)作為診斷的首選輔助檢查。腫瘤標記物檢查應(yīng)作為卵巢腫瘤常規(guī)檢查，結(jié)合臨床癥狀可更好的判定腫瘤性質(zhì)。青春期卵巢腫瘤患者的手術(shù)方式無論良惡性均應(yīng)盡量保留生育功能，首次發(fā)現(xiàn)青春期女性附件區(qū)如有囊性包塊,考慮為卵巢瘤樣病變的可暫不手術(shù)，連續(xù)動態(tài)復(fù)查B超。惡性腫瘤術(shù)后應(yīng)聯(lián)合規(guī)范化療，嚴密隨訪術(shù)后惡性腫瘤的患者。
[Abstract]:Objective: to analyze and summarize the clinical features, diagnosis and treatment of adolescent ovarian neoplasms in order to improve the early diagnosis rate and improve the prognosis. Methods: the clinical data of 105 patients with ovarian neoplasms aged 10-19 years from January 2007 to November 2012 were analyzed retrospectively. The incidence, clinical features, pathological types, auxiliary examinations, treatment methods and follow-up were analyzed. Results: 51 cases of pubertal ovarian tumors were diagnosed with abdominal pain, accounting for 48.57% of 27 cases without any symptoms, only physical examination was found, accounting for 25.71%. B-mode ultrasound showed that the incidence of malignant and borderline tumors was increased when the diameter of ovarian tumors was larger than 10cm. The ultrasound image scoring system was used to evaluate the nature of ovarian tumors. There were 93 benign tumors (88.57), 8 malignant tumors (7.61%) and 4 borderline tumors (3.80%). According to histological classification, 51 cases of germ cell tumor (48.57%), 27 cases of tumor-like lesion (25.71%), 25 cases of epithelial tumor (23.80 cases) and 1 case of sex cord interstitial cell tumor (0.955.105 cases) were treated by operation and proved by pathology after operation. The coincidence rate between intraoperative freezing and postoperative disease detection was 94.28%. Of the benign tumors, 88 cases underwent excision of ovarian cysts and 5 cases underwent resection of the affected adnexa. 3 cases of borderline tumors were treated with ovarian tumor excision. 1 case underwent appendectomy of right adnexal omentum appendectomy. 8 cases of malignant tumors were performed. Surgery that preserves fertility, Among them, 6 cases received PVB or PEB chemotherapy after operation. Conclusion: abdominal pain is the main factor in the diagnosis of adolescent ovarian tumors, followed by physical examination. The gynecological survey of adolescent women should be paid attention to. B-mode ultrasound is helpful to determine the nature of ovarian tumors before operation and should be regarded as the first choice of auxiliary examination in the diagnosis of ovarian tumors. Tumor markers should be used as routine examination of ovarian neoplasms, combined with clinical symptoms can better judge the nature of the tumor. For the first time, if there is cystic mass in the adnexal region of puberty female, it is considered that the ovarian tumor-like lesion can not be operated on for a while, and continuous dynamic reexamination of B-mode ultrasound is carried out. Postoperative malignant tumor should be combined with standard chemotherapy, closely follow up postoperative patients with malignant tumor.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.31

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