CT在卵巢畸胎瘤诊断中的价值

目的:研究卵巢畸胎瘤的CT表现。方法:全部病例做了CT扫描。结果:右侧17例,左侧18例,平均最大直径85 mm。29例圆形或椭圆形,6例不规则形。33例脂质成分存在。30例良性者23例显示瘤壁结节,7例为实性肿块,5例可见脂／液平面;5例恶性者密度不均匀。30／35例见钙化或骨化。3例恶性者并发腹膜转移。结论:发生于卵巢的含有脂质成分和钙化或骨化斑者应考虑本病诊断。     

Pelvic masses in childhood: ultrasonographic imaging

The echographic appearance of pelvic masses in children was examined in 38 patients. Sonography was correct in determining the site of origin in all cases. Cystic uterine masses and cystic ovarian masses were the most specific, representing hydrometrocolpos and benign ovarian cysts. A nonspecific sonographic pattern was encountered with complex masses, which proved to be ovarian teratomas, hemorrhagic ovarian cysts and pelvic abscesses. Although a number of characteristic features of teratomes have been described, these signs were seen very rarely in children.     

450例卵巢成熟性畸胎瘤临床病理回顾性分析

目的 :探讨卵巢成熟性畸胎瘤的临床病理特征。方法 :对 4 5 0例卵巢成熟性畸胎瘤临床病理资料进行回顾性分析。结果 :卵巢成熟性畸胎瘤占卵巢肿瘤的 36 .5 % ,占生殖细胞肿瘤的 96 .2 % ,可以发生任何年龄 ,以 2 0～5 0岁为多 (占 86 .0 % ) ,平均年龄 33岁。临床主要症状为下腹痛或下坠感 (70 .0 % ) ,以单侧生长多见 (91.2 % ) ,左右无明显差异 ;并发蒂扭转 6 2例 (13.8% ) ,感染 14例 (3.1% ) ,破裂 6例 (1.3% ) ,恶变 5例 (1.1% )。组织学检查 ,外、中、内 3个胚叶组织分别占 10 0 .0 %、 73.9%和 32 .1%。结论 :对卵巢成熟性畸胎瘤应及时手术治疗 ,以减少并发症的发生     

妊娠合并卵巢肿瘤99例分析

目的 分析妊娠合并卵巢肿瘤的临床特征,探讨其诊断和处理对策.方法 回顾性分析99例妊娠合并卵巢肿瘤的临床资料.结果 99例妊娠合并卵巢肿瘤中成熟畸胎瘤、黄体囊肿、内膜异位囊肿发生率分别为28.2%、23.3%、12.6%,卵巢肿瘤发生蒂扭转7例,发生破裂2例.妊娠合并卵巢恶性肿瘤3例(2.9%).孕期卵巢肿瘤手术孕周为9～25周,术后无发生流产病例.结论 妊娠合并卵巢肿瘤以成熟畸胎瘤多见,其主要并发症为囊肿蒂扭转和破裂,妊娠合并卵巢肿瘤的处理取决于孕周、包块生长情况、性质以及有无并发症.     

MRI在卵巢良性囊性病变诊断中的临床价值

目的：探讨MRI在卵巢良性囊性病变诊断中的临床价值,以提高其诊断及鉴别诊断的水平。方法收集外院2009-2013年经手术及病理证实的173例卵巢良性囊性病变,回顾性分析、总结其MRI特征性表现。结果173例卵巢良性囊性病变中卵巢囊肿65例,子宫内膜异位囊肿57例,成熟囊性畸胎瘤34例,囊腺瘤17例,其中4例畸胎瘤合并卵巢囊肿,12例子宫内膜异位囊肿合并卵巢囊肿,2例囊腺瘤合并卵巢囊肿。MRI检出165例囊性病变部位与手术病理一致,准确率为95.4%,152例MRI诊断与手术病理结果符合,符合率为87.9%。结论 MRI在卵巢良性囊性病变的定位、定性及鉴别诊断方面有相当重要的价值,能很好的显示出病变的组织学特征及与邻近组织的关系,为术前评估提供可靠的依据。     

Evaluation of diagnosis of ovarian malignancy using immunohistochemical technique.

Immunohistochemical staining was performed on biopsy specimens from normal ovary and also from abnormal ovarian growth using monoclonal OKT9 antibody. The results showed positive reaction in 8.77% of normal ovarian specimens removed during laparotomy. The reaction was also positive in 15.7% in cases diagnosed by histological examination as benign ovarian growth. Specimens proved by histological examination to be malignant showed reaction with OKT9 in 100%. The significance of this finding is discussed.     

Mature cystic teratoma of the fallopian tube. A case report

Primary teratomas of the fallopian tube are extremely uncommon. To date, only about 50 cases have been reported in the literature. They occur usually in the fourth decade. There association with nulliparity and reduced parity has been noted. Many have been discovered incidentally and none has been diagnosed preoperatively. The majority are cystic, show great variation in size and are commonly located in the ampulla or the isthmus. They can be intraluminal, attached to the serous surface by a pedicule and rarely intramural. Histologically they are similar to teratoma of the ovary and elsewhere. We describe a mature cystic teratoma of the fallopian tube found incidentally in a 35-year-old woman operated for suspicion of ectopic tubal pregnancy. The feature of benign teratoma of the fallopian tube is discussed.     

卵巢成熟性畸胎瘤273例临床分析

目的对卵巢成熟性囊性畸胎瘤的临床特点进行分析。方法回顾性分析2002-07/2007-07在绵阳市中心医院首诊并行手术治疗的卵巢畸胎瘤273例,其中卵巢畸胎瘤恶变2例,对其临床特点进行分析。结果卵巢成熟性囊性畸胎瘤好发于生育年龄,以单侧肿瘤多见（81.3%）,右侧略多于左侧（44.85%和36.44%）,其恶性变很罕见,恶变率为2%~4%,多发生于40岁以后,多为绝经后女性。两类肿瘤中CA199均有较高的阳性率,术前测定CA199作为二者的鉴别指标可能意义不大。结论要加强对妇女的妇科检查,对于40岁以上妇女的卵巢成熟性囊性畸胎瘤,肿瘤体积偏大的,应警惕其恶变的可能。卵巢成熟性畸胎瘤预后较差。     

腹腔镜手术和开腹手术治疗老年卵巢囊肿疗效观察

目的 探讨腹腔镜手术与开腹手术治疗卵巢囊肿的临床疗效.方法 对2004年6月～2011年10月期间在某院行良性卵巢囊肿手术治疗的78例老年患者临床资料进行了回顾性分析,分析两组患者术中出血量、手术时间、术后排气时间、术后3d之内平均体温、住院时间、住院费用、患者手术方式及手术标本病理检查结果.结果 分析两组患者手术时间、术中出血量、术后排气时间、住院费用、住院时间等指标,两组之间比较差异有统计学意义(P＜0.05);手术方式比较,开腹组行囊肿剥除术者2例,附件切除术19例,腹腔镜组行囊肿剥除术者11例,附件切除术者46例,两组在手术方式上比较差异无统计学意义(P＞0.05);病理检查囊肿性质主要为炎症性囊肿、成熟畸胎瘤、浆液性囊腺瘤、粘液性囊腺瘤等为主,腹腔镜组及开腹组患者均以炎症性囊肿所占构成比最高,腹腔镜组为38.60％,开腹组为57.14％,其次为成熟畸胎瘤,腹腔镜组为17.54％,开腹组为14.29％.结论 腹腔镜手术治疗老年卵巢囊肿较开腹手术治疗有术后恢复快、并发症少等优点,但并不能完全取代开腹手术,选择何种术式要根据患者的病情特点决定.     

以腹水为主要表现的罕少见病病因探讨

目的 探讨以腹水为主要表现的罕少见病的病因诊断及诊断方法,对我科12例入院诊断为腹水查因的患者进行回顾性分析,方法 对我科12／61例入院诊断为腹水查因患者分别进行了腹水多项检查、胃镜、腹部和（或）妇科B超、血管造影、剖腹探查等多项检查,最终经病理和（或）手术证实。结果 12例患者中正常大小卵巢癌综合症4例、Budd-Chiari综合征4例、腹膜假性粘液瘤2例、原发性十二指肠癌、 发性脾破裂致被膜下出血反应性腹膜炎致腹水1例。结论 以腹水为主要表现的罕少见病以Budd-Chiari综合征、女性患者正常大小卵巢癌综合征为最常见病因,其次为其他罕见病,疑为Budd-Chiari综合征血管造影有确诊意义、正常大小卵巢癌综合征血CA125有诊断意义。     

腹腔镜卵巢畸胎瘤切除术中瘤体破裂的影响因素及预后

目的:分析腹腔镜卵巢畸胎瘤剥除术术中瘤体破裂的相关因素和对患者预后的影响。方法:回顾性分析2003年1月～2006年3月141例腹腔镜畸胎瘤切除术患者的临床资料,按瘤体是否破裂分为瘤体破裂组和瘤体未破裂组,比较两组的一般情况、肿瘤情况、手术情况和预后情况。结果:141例均于腹腔镜下完成手术,128例行畸胎瘤剥除术,13例行附件切除术,共切除瘤体157个,瘤体直径为3～10cm。术中瘤体破裂42例,均在行剥除术时发生,其中1例双侧瘤体均破裂,共破裂瘤体43个,32个(74.4%)瘤体破口位于靠近卵巢门侧的半个瘤体,11个(25.6%)瘤体破口位于远离卵巢门侧的半个瘤体;瘤体破裂组与未破裂组一般情况无明显差异(均P>0.05);两组间肿瘤大小和位置也无明显差异,但瘤体破裂组瘤体周围粘连比例明显高于瘤体未破裂组(P<0.01);瘤体破裂组手术时间明显长于瘤体未破裂组(P<0.05);两组间术中出血量无明显差异(P>0.05);两组间术后恢复情况也无明显差异(P>0.05)。结论:腹腔镜卵巢畸胎瘤切除术术中瘤体破裂主要在行瘤体剥除术处理卵巢门时发生,其次是瘤体与周围有粘连所致,瘤体破裂后经正确处理对患者预后无明显影响。     

Malignant degeneration of mature benign teratoma of the ovary: a case report

Malignant transformation of ovarian mature benign teratomas is an uncommon complication which often occurs in the postmenopausal period. Clinical presentation is similar to that of benign ovarian cysts. The diagnosis of malignant transformation is often made per-operatively by the break of the capsule and the adhesions of the tumor or during histological examination. The diagnosis is based on the association between a mature teratoma and a non metastatic unitissular, carcinoma or sarcoma. All histological forms can be met, but squamous cell carcinoma accounts for 75% of all cases. We report the case of a 70-year-old woman who had a squamous cell carcinoma which developed on a teratoma of the ovary, for whom the disease was fatal. The survival rate for this kind of ovarian tumour is reduced, with 15 to 30% survival after 5 years, irrespective of stages and histological types. Although it is not easy to define the best requested therapy, surgery associated with polychemotherapy or radiotherapy is apparently the only way of improving the poor prognosis for these tumours.     

Endometrial and ovarian tumours and their association with obesity

A 53-year-old woman was wheelchair-dependent and unable to work due to an extreme increase in abdominal circumference. Closer investigation revealed an ovarian tumour. A mucinous cystadenoma of the ovary weighing more than 20 kg was removed with laparotomy. A 63-year-old woman presented with postmenopausal haemorrhage. Morbid obesity and agoraphobia had prevented her from visiting a doctor earlier. She was eventually diagnosed with stage 1C grade III endometrial carcinoma, which was treated with surgery and vaginal brachytherapy. The incidence of gynaecological tumours is increased in patients with a high BMI. This association is stronger for endometrial carcinoma than for ovarian carcinoma. Obesity has a favourable influence on the histological grade of endometrial carcinoma, and is associated with lower-stage ovarian cancer. Surgery-related complications are more common in obese patients. Determining the optimal dose of adjuvant therapy is also problematic in obese patients.     

Aggregation of ovarian cancer with breast, ovarian, colorectal, and prostate cancer in first-degree relatives

Epidemiologic studies have demonstrated a tendency for common cancers to aggregate in families. The authors investigated the effects of family history of cancer at multiple sites, including the breast, ovary, colorectum, and prostate, on ovarian cancer risk among 607 controls and 558 ovarian cases in Hawaii and Los Angeles, California, in 1993-1999. A family history of cancer of the breast, ovary, colorectum, or prostate in first-degree relatives was associated with an increased risk of ovarian cancer (odds ratio (OR)=1.7, 95% confidence interval (CI): 1.1, 2.6; OR=3.2, 95% CI: 1.3, 7.9; OR=1.5, 95% CI: 0.9, 2.5; and OR=1.6, 95% CI: 1.0, 2.8, respectively). A greater risk of ovarian cancer was observed for women with parents rather than siblings with a history of breast or prostate cancer and for women with parental colorectal cancer diagnosed at an early age, suggesting a genetic predisposition among these women. The risk of nonmucinous tumors, but not mucinous tumors, was positively associated with a family history of cancer. No significant interaction effects on risk existed between oral contraceptive pill use or pregnancy and family history of breast and/or ovarian cancer. Study findings suggest that ovarian cancer aggregates with several common cancers in family members.     

50例卵巢囊性畸胎瘤的超声显像特征与诊断

目的：对卵巢囊性畸胎瘤超声显像特征进行分析与诊断,以提高卵巢囊性畸胎瘤的确诊率。方法：选取本院50例卵巢囊性畸胎瘤患者,对其进行超声显像技术处理,将收集到的资料进行分析。结果：卵巢囊性畸胎瘤超声显示回声与其结构有明显的关系,大量的油脂样物、毛发、软骨、甲状腺等使畸胎瘤具有明显的超声图像特征。结论：超声显像检查结果准确可靠,应作为卵巢囊性畸胎瘤的首选检查方法。     

60例妊娠合并卵巢肿瘤临床资料分析

目的 研究妊娠合并卵巢肿瘤的临床特征,探讨其诊断方法和处理对策。 方法回顾性分析广西百色地区人民医院1991年1月-2000年1月10年间60例妊娠合并卵巢肿瘤病例的临床特征、诊治方法和妊娠结局。 结果 妊娠合并卵巢肿瘤的发生率为5.3‰(60/11 396)。其中卵巢良性肿瘤占45.0%(27/60),卵巢瘤样变占51.7%(31/60),卵巢恶性肿瘤占3.3%(2/60)。在所有卵巢肿瘤中,卵巢成熟型畸胎瘤最多见,占30.0%(18/60);第2位的是卵巢巧克力囊肿,占20.0%(12/60)。妊娠合并卵巢肿瘤常见的并发症为蒂扭转、肿物破裂和产道梗阻,发生率分别为11.7%(7/60)、3.3%(2/60)和3.3%(2/60)。60例中足月妊娠53例,早产4例,流产2例,人工流产1例。其中早产1例及流产2例病人发生急腹症行急诊手术,5例于孕16-22周行卵巢囊肿剥出术者,无1例发生流产。 结论 妊娠合并卵巢肿瘤以成熟型畸胎瘤最常见;为避免急腹症、流产和早产的发生,于妊娠16-22周行选择性手术是相对安全的。     

腹腔镜手术与开腹手术治疗良性卵巢囊肿的临床对比分析

目的:比较腹腔镜术与开腹术两种方法行良性卵巢囊肿手术的效果。方法:将妇科手术治疗的150例良性卵巢囊肿患者随机分为腹腔镜组(73例)和开腹术组(77例),对两组患者的特征及手术效果进行回顾比较分析。结果:两组在年龄、剖腹术史、囊肿大小、病理类型、手术时间等方面差异无显著性(P>0.05),而在术后发热率、对镇痛药的需求、术后住院日及恢复时间,腹腔镜组显著减少(P<0.01或P<0.05)。结论:在严格选择病例的前提下进行腹腔镜下卵巢囊肿手术,创伤小,术后恢复快,优于传统的开腹手术,有较大的应用价值。     

腹腔镜诊治女性不孕症盆腔病变468例分析

目的: 探讨腹腔镜在女性不孕症盆腔病变患者中的诊治价值。方法: 应用腹腔镜对 468例不孕症患者的盆腔病变作出诊断, 并镜下美蓝通液试验动态观察输卵管的通畅情况, 同时进行相应的镜下手术治疗。结果: 468例不孕症患者中, 患有盆腔疾病者 457例, 占 97.65%。其中盆腔炎症居首位, 子宫内膜异位症次之, 多囊卵巢居第 3位。双侧输卵管不通者盆腔炎占 81. 65%, 子宫内膜异位症占 11. 00%。对输卵管远端阻塞行输卵管伞口扩张术或输卵管造口术后, 输卵管恢复通畅率为63. 71%。结论: 腹腔镜检查可以明确不孕症的盆腔病因, 观察输卵管的通畅情况, 同时进行手术治疗, 对于原因不明的不孕患者, 及早行腹腔镜检查以明确诊断和治疗, 大大缩短了诊疗时间。     

腹腔镜手术治疗卵巢成熟性畸胎瘤212例临床分析

目的分析腹腔镜下治疗卵巢成熟性畸胎瘤的效果及临床价值。方法回顾性分析应用腹腔镜治疗卵巢成熟性畸胎瘤212例,并与同期开腹组治疗成熟性畸胎瘤进行比较。结果 212例患者腹腔镜手术全部成功,无1例中转开腹。平均手术时间(48.7±11.8)min,术中出血量(31.3±5.7)ml,离床时间(8.1±2.5)h,肛门排气时间(10.4±3.5)h,术后拔除尿管时间(8.5±3.4)h,住院时间(4.5±1.1)d。随访1～3年未发现化学性腹膜炎、肉芽肿及复发病例。结论腹腔镜下卵巢成熟性畸胎瘤剔除术安全、有效,且具有微创、术后恢复快、并发症少等优点,可作为首选的治疗方法。     

开腹手术与腹腔镜治疗卵巢子宫内膜异位囊肿的疗效比较

目的:比较腹腔镜手术和传统开腹手术治疗卵巢子宫内膜异位囊肿的临床疗效。方法:将60例卵巢子宫内膜异位囊肿患者按住院治疗的先后顺序随机分为观察组和对照组,每组30例,观察组采用腹腔镜手术,对照组采用传统开腹手术,术后给予抗生素对症治疗3天。观察两组手术持续时间、切口长度、术后卧床时间、术后镇痛剂使用情况、肛门排气时间以及残端出血、切口感染、肠梗阻等并发症发生情况。结果:两组患者均顺利完成手术,均成功切除卵巢肿块,手术成功率达100.00%。手术时间、术后疼痛时间、术中出血量、肛门排气时间、下床时间、住院时间、术后镇痛药使用率、治疗总费用,观察组均优于对照组(P<0.05)。观察组并发症发生率为6.66%,对照组并发症发生率为13.33%。结论:腹腔镜手术治疗卵巢子宫内膜异位囊肿与传统开腹手术相比,创伤小、术后恢复快、术后并发症少。