妊娠合并卵巢交界性肿瘤13例临床特征分析

Clinical characteristics analysis of 13 cases of pregnancy complicated with borderline ovarian tumors

关键词:  妊娠  卵巢交界性肿瘤  临床特征  诊断  手术治疗

Key words:  pregnancy  borderline ovarian tumors  clinical features  diagnosis  surgical treatment

摘要:

目的 探讨妊娠合并卵巢交界性肿瘤（borderline ovarytumours，BOTs）的临床特点，分析手术疗效。方法 收集2004年5月至2018年5月大连市妇幼保健院诊治的13例妊娠合并BOTs患者的临床资料。患者平均年龄（30.7±4.71）岁，平均孕次1.8次（1~4次），平均产次0次（0~1次），行卵巢囊肿剔除术6例，患侧附件切除术7例，总结妊娠合并BOTs的临床、影像学及病理特征，并分析手术治疗效果。结果 13例患者中10例无明显临床症状，2例下腹痛、1例恶心呕吐，患者超声9例提示卵巢肿物内为液暗区伴光点、光带或光团，无明显特异性表现。12例患者剖宫产术同时行保留生育功能的手术治疗，1例患者孕晚期行患侧附件切除术，后经阴道自然分娩；13例新生儿Apgar评分均10分。结论 妊娠合并BOTs的患者无明显临床症状及影像学表现，术前易诊断不全或漏诊，应根据患者年龄、有无生育要求、是否保留胎儿、妊娠时期、肿瘤期别、病理组织类型等选择合适的治疗方式以确保母婴安全。

Abstract:

Objective To explore the clinical characteristics of pregnancy combined with borderline ovarian tumors (borderline ovary tumours,BOTs), and analyze the surgical efficacy. Methods Clinical data were collected from 13 patients with borderline ovarian tumors from Dalian Maternal and Child Health Hospital from May 2004 to May 2018.The mean age of the 13 patients was (30.7±4.71) years-old, average pregnancy was 1.8 (1-4), average birth was 0 (0-1),Six of the 13 patients had oophorocystectomy and seven had adnexectomy, summary the clinical, imaging and pathological characteristics of pregnancy with BOTs, and the surgical treatment effect was analyzed. Results Ten of the 13 patients had no significant clinical symptoms, two with abdominal pain and one with nausea and vomiting.Nine patient's ultrasound suggested that the dark area with light spots, light bands or optical masses in the ovarian mass, with no obvious specific imaging manifestations. Twelve patients retained reproductive function during cesarean section, 1 patient underwent annexectomy in the late pregnancy and underwent natural transvaginal delivery, the apgar scores of 13 cases were all 10 points. Conclusion Patients with borderline ovarian tumor during pregnancy had no significant clinical symptoms and imaging findings, are prone to incomplete diagnosis or missed diagnosis before surgery, which should arouse clinical precaution. Appropriate treatment methods should be selected according to the patient's age, fertility requirements, fetus preservation requirements, pregnancy phase, tumor stage, and pathological tumor type to ensure the safety of the mothers and infants.