妊娠合并卵巢肿瘤的治疗及预后

目的 探讨妊娠合并卵巢肿瘤的特征、诊断、治疗、相互影响及预后。方法 对近5年我院收治及手术、病理诊断明确的105例妊娠合并卵巢肿瘤进行回顾性分析。结果 妊娠期卵巢肿瘤病理类型，生殖细胞肿瘤占44．8％(47／105)，体腔上皮来源的肿瘤和性索间质肿瘤各占19．0％(20／105)，卵巢非赘生性囊肿占17．1％(18／105)；恶性肿瘤发生率为1．9％(2／105)。恶性肿瘤多为I期，术后随访至今无明显异常。足月妊娠率95．2％(100／105)。孕中期因卵巢肿瘤蒂扭转急症手术2例、因肿瘤增大明显手术2例。结论 妊娠合并卵巢良性肿瘤可予定期监测、择期处理，良性肿瘤妊娠时手术最佳时间孕16～20周，恶性肿瘤则应及时手术。除急症或肿瘤可疑恶变需及时手术外，妊娠可至足月。

The treatment and prognosis of pregnancy with ovarian tumor

Objective To explore the characteristics,diagnosis,treatment and prognosis of the pregnancy with ovarian tumor,and to explore the mutual interaction between pregnancy and ovarian tumor. Methods A retrospective analysis of treatmens of 105 cases that were treated,operated and diagnosed pathologically as pregnancy with ovarian tumor had been conducted in our hospital in the recent 5 years. Results The types of pregnancy with ovarian tumor we found are epithelial ovarian tumor 44 8 %(47/105),sex cord stromal tumor 19 0 %(20/105),and germ cell tumor 19 0 %(20/105),the percentage of malignant cases is 1 9 %(2/105),the non necoplastic tumor of ovary,17 1 %(18/105).Most of the malignant cases are in stage I and there is not obvious abnormal case after operation,which is indicated by the follow up.The uterogestation rate is 95 2 %(100/105).Two cases were given urgent operation during the midterm of pregnancy because of the twisting of pedicle of ovarian tumors,and another two cases were given urgent operation during the midterm of pregnancy because of obvious increaing of the size of ovarian tumor. Conclusion The cases of pregnancy with benign ovarian tumor can be monitored periodically,and given operations at selected time.The best time for operation is between 16 to 20 weeks after pregnancy,but the malignant cases should have operation in time.Except for the urgent cases the possible malignant changes of the tumor that should conducted operation in time,pregnancy can last to uterogestation.