妊娠合并卵巢肿瘤的临床特征及处理

目的：探讨妊娠合并卵巢肿瘤的特点及处理方式对妊娠结局的影响。方法：对天津市中心妇产科医院2012年1月至2013年6月间收治并经手术证实及病理诊断的122例妊娠合并卵巢肿瘤病例进行回顾性分析。结果：妊娠合并卵巢肿瘤患者占总分娩人数的0.79%（期间分娩共15 458例）,9例于孕前发现,20例为孕早期发现,3例孕中期发现,90例孕晚期发现（包括剖宫产术中发现）;1例于早孕期行囊肿剔除术,4例于孕中期行囊肿剔除术,117例于孕晚期剖宫产术中行手术治疗;孕期发现蒂扭转5例（4.10%）,破裂3例（2.46%）,其中直径〉5 cm的肿物更易发生并发症（P〈0.05）,孕中期较孕早晚期更易发生并发症（P〈0.05）;122例患者肿瘤数为135个,其中良性肿瘤129个,以子宫内膜异位囊肿及畸胎瘤为主;新生儿均无异常。结论：在孕期适时进行手术干预对于妊娠合并卵巢肿瘤的患者及胎儿是安全的,剖宫产术中发现卵巢肿瘤时行剔除术是必要的。

Clinical Characteristics and Management of Ovarian Tumor During Pregnancy

Objective： To investigate the clinical characteristics and management of ovarian tumor during pregnancy. Methods： A retrospective analysis of 122 cases of pregnancy complicated with ovarian neoplasm was made,treated and confirmed by operation and pathological diagnosis in Tianjin Central Hospital of Obstetrics and Gynecology from Juanary 2012 to June 2013. Results： The patients with ovarian tumor during pregnancy account for 0. 79 % of total delivery women in the same period. Of 122 patients,9 cases were diagnosed before pregnancy,20 cases in the first-trimester,3 cases in the second-trimester and 90 cases in the third-trimester（ including those during cesarean operation）. 1 case underwent cystectomy in early pregnancy,4 cases in the second-trimester and 117 cases during cesarean operation in the third-trimester. There were 5 cases of ovarian tumor torsion（ 4. 10 %） and 3 cases of ovarian tumor rupture（ 2. 46 %）. The complications of cyst more often occurred in the second-trimester than in other periods（ P 0. 05） and the diameter above 5 cm had higher risk of complications（ P 0. 05）. There were 135 cysts in 122 patients,with 129 benign tumors among them and ovarian endometrial cyst and teratoma in dominance. Neonates were normal. Conclusion： The intervention to ovarian tumor during pregnancy by operation at proper time is safe to women and their neonates. It is necessary that the ovarian tumor should be eliminated at the same time when it was found in cesarean section.