【摘要】：目的探討妊娠合并卵巢腫瘤及瘤樣病變的診斷方式、病理類型和妊娠結(jié)局，以指導(dǎo)妊娠合并卵巢腫瘤及瘤樣病變的臨床診治。 方法回顧性分析我院2009年1月~2012年12月收治的106例妊娠合并卵巢腫瘤及瘤樣病變患者，根據(jù)分娩方式，將其分為陰道分娩組（A組）及剖宮產(chǎn)組（B組）；依據(jù)孕期超聲檢查結(jié)果，將B組分為分娩前診斷組（B1組）及術(shù)中診斷組（B2組）；根據(jù)診斷方式，分為超聲診斷組（A組+B1組）和術(shù)中診斷組（B2組）。對(duì)A組孕期診斷情況和孕期卵巢腫物大小進(jìn)行分析；對(duì)B1組孕期超聲診斷、B1和B2組術(shù)中探查卵巢腫物大小及病理診斷類型進(jìn)行分析；對(duì)超聲診斷組（A+B1組）的診斷時(shí)間、超聲檢查腫瘤大小的變化進(jìn)行分析。 結(jié)果本組妊娠合并卵巢腫瘤及瘤樣病變患者占同期總分娩人數(shù)0.72%。106例患者分娩前診斷63例（59.43%），其中孕前診斷15例、孕早期診斷32例、孕中期診斷11例、孕晚期診斷5例，剖宮產(chǎn)同時(shí)發(fā)現(xiàn)43例（40.57%）。病理類型以卵巢子宮內(nèi)膜異位囊腫最為多見（35.96%），其次為成熟性囊性畸胎瘤（24.72%）、卵巢黃體囊腫（10.11%）、黏液性囊腺瘤（7.87%）。經(jīng)陰道分娩17例，剖宮產(chǎn)89例；單胎104例，雙胎2例，獲得新生兒107名；足月產(chǎn)100例，早產(chǎn)6例；新生兒窒息9例，死胎1例。 結(jié)論妊娠合并卵巢腫瘤及瘤樣病變多數(shù)為良性病變，卵巢子宮內(nèi)膜異位囊腫是妊娠合并卵巢腫瘤及瘤樣病變常見的病理類型，，孕早中期的超聲檢查有助于診斷但有局限性，剖宮產(chǎn)同時(shí)雙附件區(qū)的探查是必要的。妊娠結(jié)局良好，孕期絕大多數(shù)無需過多干預(yù)。
[Abstract]:Objective to investigate the diagnosis, pathological types and pregnancy outcome of ovarian neoplasms and tumor-like lesions in pregnancy, so as to guide the clinical diagnosis and treatment of ovarian neoplasms and tumor-like lesions in pregnancy. Methods from January 2009 to December 2012, 106 cases of pregnancy complicated with ovarian neoplasms and tumor-like lesions were retrospectively analyzed. According to the delivery mode, 106 cases were divided into vaginal delivery group (group A) and cesarean section group (group B). According to the results of ultrasound examination during pregnancy, group B was divided into pre-delivery diagnosis group (B1 group), intraoperative diagnosis group (B2 group), ultrasonic diagnosis group (A group B1 group) and intraoperative diagnosis group (B2 group). The diagnosis and size of ovarian mass during pregnancy were analyzed in group A, ultrasound diagnosis during pregnancy in group B1, the size of ovarian mass and the type of pathological diagnosis in group B1 and B2 during operation were analyzed. The diagnostic time and tumor size of ultrasonic diagnosis group (A B1 group) were analyzed. Results 63 cases (59.43%) were diagnosed before delivery, 15 cases were diagnosed before pregnancy, 32 cases were diagnosed in early pregnancy, 11 cases were diagnosed in second trimester of pregnancy. 5 cases were diagnosed in the third trimester of pregnancy, 43 cases (40.57%) were found at the same time by cesarean section. The most common pathological types were ovarian endometriosis cysts (35.96%), mature cystic teratoma (24.72%), ovarian luteal cyst (10.11%) and mucinous cystadenoma (7.87%). There were 17 cases of vaginal delivery, 89 cases of cesarean section, 104 cases of single fetus, 2 cases of twins, 107 cases of newborns, 100 cases of term delivery, 6 cases of premature delivery, 9 cases of neonatal asphyxia and 1 case of stillbirth. Conclusion most of pregnancy complicated with ovarian tumors and tumor-like lesions are benign lesions. Ovarian endometriosis cyst is a common pathological type of pregnancy complicated with ovarian tumors and tumor-like lesions. Ultrasound examination in the second trimester of pregnancy is helpful for diagnosis but limited. Exploration of both adnexal areas at the same time of cesarean section is necessary. Pregnancy outcome is good, the vast majority of pregnancy without too much intervention.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.25;R737.31


本文編號(hào)：2414909