卵巢囊肿蒂扭转在绝经后与育龄期患者中的临床特征比较

目的：探讨卵巢囊肿蒂扭转在绝经后与育龄期患者中的临床特征比较。方法将2013年6月至2016年6月间西安交通大学第一附属医院妇产科收治的78例卵巢囊肿蒂扭转患者根据是否绝经分为育龄期组（59例）和绝经组（19例），收集其临床资料并进行回顾性分析。结果同育龄期组相比，绝经组卵巢囊肿蒂扭转的临床表现多样、B超诊断符合率及术前诊断符合率较低。在囊肿直径（ t＝2．091，P＝0．042）、发病至术前时间（ t＝2．160，P＝0．048）及肿瘤性质方面（用Fisher确切概率检验，P＝0．013）的差异均有统计学意义，在白细胞计数、中性粒细胞计数、中性粒细胞百分比方面未见明显统计学差异（ t值分别为0．709、0．737、0．619，均P＞0．05），在手术方式、扭转方向、扭转圈数上的差异无明显统计学意义（χ2值分别为0．557、1．393、2．063，均P＞0．05）。育龄期组与绝经组相比较，在B超诊断符合率（χ2＝5．631，P＝0．018）、术前诊断符合率（χ2＝7．401，P＝0．007）、术中冰冻应用率（χ2＝6．941，P＝0．008）方面具有明显的统计学差异。结论同育龄期患者相比，绝经后患者的临床表现不典型、辅助检查缺乏特异性，导致术前诊断符合率低、治疗延迟，且由于绝经后患者卵巢肿瘤恶性率较高，致使手术范围扩大。

Comparison of clinical characteristics of pedicle torsion of ovarian cysts between postmenopausal and reproductive women

Obejective To compare the clinical characteristics of pedicle torsion of ovarian cysts between reproductive and postmenopausal women .Methods Retrospective analysis was conducted on clinical data of 78 patients with ovarian cyst pedicle torsion recruited in the First Affiliated Hospital of Xi’an Jiaotong University from June 2013 to June 2016.These patients were divided into reproductive group (59 cases) and postmenopausal group ( 19 cases ) based on menopause status . Results Compared to reproductive women , clinical manifestations in postmenopausal women were various , and B -ultrasound diagnostic accordance rate and preoperative diagnostic accordance rate were lower in postmenopausal women .Statistical significance between two groups was observed in cysts ’ diameter ( t=2.091,P=0.042), interval time before operation (t=2.160,P=0.048) and tumor’s characteristics(P=0.013 in Fisher exact test), yet the differences in leukocyte counts , neutrophil counts and neutrophil percentage were not significant ( t value was 0.709, 0.737 and 0.619, respectively, all P >0.05).There were no significant differences in surgical procedures , torsional direction and number of torsional cycles (χ2 value was 0.557, 1.393 and 2.063, respectively, all P>0.05).The comparison in diagnostic accordance rates of B-ultrasound (χ2 =5.631, P =0.018 ), preoperative diagnostic accordance rate (χ2 =7.401, P =0.007 ) and utilization rate of intraoperative frozen (χ2 =6.941, P =0.008 ) showed obvious significance .Conclusion Compared to reproductive women , clinical manifestations in postmenopausal women are atypical and auxiliary examinations are nonspecific , leading to lower preoperative diagnostic accordance rate and delayed treatment .And rather high rate of ovarian malignancy contributes to the expending of surgical range .