B超介导下穿刺诊断与治疗卵巢巧克力囊肿

目的 探讨B超介导下囊肿穿刺术对卵巢巧克力囊肿的诊断价值和治疗意义。方法 对52例临床诊断巧克力囊肿患者在B超下行肿囊穿刺术，以囊液性状和涂片病理作出诊断，同时对部分诊断囊肿者囊腔内注入甲孕酮。随访12个月以上。结果 经穿刺术校正诊断7例（13．46％）。穿刺术使患者近期症状缓解率达100％，甲孕酮可使复发率显著减低。复发病例可行第二次穿刺术并加甲孕酮治疗仍有效。结论 B超下的囊肿穿刺术是对卵巢巧克力囊肿的一种可行的微创性诊断与治疗方法，甲孕酮囊腔内给药和术后维持治疗能有效地控制症状和促使异位病灶萎缩。

A Mini-invasive Technique with Ultrasound-Guided Aspiration for Diagnosis and Treatment of Ovarian Chocolate Cyst

Objective\ To assess the feasibility of a mini\|invasive technique with ultrasound\|guided aspiration of adnexal cysts and injecting medroxprogesterone(DMPA) into it for diagnosis and treatment of ovarian chocolate cyst.\ Methods\ 52 cases of adnexal cysts were submitted to transabdominal or transvaginal ultrasound\|guided aspiration of the cyst content, and if the aspirated fluid was chocolate like, DMPA or alcohol was injected into the empty cyst.\ The final diagnosis was made according to the characteristics of the aspirated fluid and cytopathology as well.\ All cases had been followed up more than 12 months.\ Results\ Operations were successful in all cases, and no early complications occurred.\ Diagnosis was corrected in 7 cases(13 46%).\ Cytopathology and serum CA125 determination were helpful to distinguish chocolate cyst from malignant ovarian tumors.\ After aspiration all patients' symptom of dysmenorrhea was improved, and observed that some patient had recurrence within 6 months, the group adding DMPA presented a better control in symptom of dysmenorrhea and recurrence.\ The recurrent cases who received a second aspiration and adding DMPA would still gain improvement in relieving symptoms.\ The main side effects of DMPA are irregular bleeding and spotting, and also depressing ovulation for a long time.\ In the process of our study,in the group of using DMPA no one got pregnancy.\ \{Conclusion\}\ Ultrasound\|guided aspiration of adnexal cyst is a convenient and minimal invasive technique for the diagnosis and therapy of ovarian chocolate cyst.\ It is effective to control symptom and promote ectopic chocolate cyst atrophy by giving DMPA.