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卵巢巨大包块 311 例临床分析

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目的:探讨卵巢巨大包块(平均径线≥10 cm)的临床和病理特征,并分析不同年龄层患者的临床特点。方法:回顾性分析2014 年1 月至 2022 年 12 月于南京大学医学院附属鼓楼医院经手术确诊的311 例来源于卵巢的巨大包块患者的临床和病理特点。并将患者按年龄和包块平均径线进一步分层,比较不同年龄组和不同包块平均径线组临床和病理特征的差异。结果:①患者中位年龄44(24,60)岁。首发症状依次为体检发现卵巢包块、腹痛、腹胀、自觉腹部膨隆、出现压迫症状。②手术方式依次为:单侧卵巢切除术(30。5%,95/311),卵巢囊肿剥除术(28。9%,90/311),肿瘤分期或肿瘤细胞减灭术(28。0%,87/311),全子宫+双侧附件切除术(12。5%,39/311)。③病理类型为:良性(49。5%,154/311)、恶性(31。8%,99/311)、交界性(18。7%,58/311)。④<20 岁组患者因发现腹部膨隆就诊者,显著高于其他两组(P<0。05)。>50 岁组的卵巢切除率高于其他两组(P<0。05),且<20 岁组患者的单侧卵巢切除率仍高达 30。1%(15/49)。⑤包块大小与病程的长短相关,病程1~6 月时,包块径线>30 cm者最常见(P<0。05)。>30 cm组交界性肿瘤的发生率显著高于其他两组,差异有统计学意义(P<0。05)。结论:卵巢巨大包块以卵巢黏液性及卵巢交界性黏液肿瘤多见。包块大小随病程的延长有增大趋势,且随着包块增大,交界性肿瘤发生率随之升高。同时应加强年轻群体的健康宣教,当出现腹痛、腹胀,尤其是下腹膨隆时应及时就诊,以避免因交界性肿瘤等切除卵巢。
Clinical Analysis of 311 Cases with Giant Ovarian Mass
Objective:To analyze the clinicopathological features of giant ovarian masses(mean diameter≥10 cm)and analyze the clinical characteristics of patients in different age groups.Methods:The clinicopathological characteristics of 311 patients diagnosed with giant ovarian masses by surgery at Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from January 2014 to December 2022 were retrospectively analyzed.Patients were further stratified by age and mass size to compare the differences of clinical and patho-logical features among different age groups and different mass diameter groups.Results:①The median age of thepatients were 44(24,60)years old.The first symptoms were as follows:ovarian mass discovered during physi-cal examination,abdominal pain,bloating,conscious abdominal distension,and symptoms of compression.②The surgical methods were as follows:unilateral oophorectomy(30.5%,95/311),ovarian cystectomy(28.9%,90/311),tumor staging or cytoreductive surgery(28.0%,87/311),total hysterectomy with bilateral adnexectomy(12.5%,39/311).③The pathological types were benign(49.5%,154/311),malignant(31.8%,99/311)and borderline(18.7%,58/311).④ Patients complained abdominal distension in<20 years old group were signifi-cantly higher than the other two groups(P<0.05).The ovarian resection rate in the>50-year-old group was higher than that of the other two groups(P<0.05),and the rate of unilateral ovarian resection in the<20-year-old group was still as high as 30.1%(15/49).⑤ The size of the mass correlated with the duration of the disease.When the disease course was between 1 to 6 months,the mass diameter line>30 cm was the most common(P<0.05).The incidence of borderline tumors in the>30 cm group was significantly higher than that in the other two groups,and the difference was statistically significant(P<0.05).Conclusions:Ovarian mucinous and mucinous borderline tumors are the most common types of giant adnexal masses.The size of the mass tends to increase with the prolongation of the disease course.The incidence of borderline tumors increases with the in-crease of mass.Health education for young people should be strengthened.When abdominal pain,abdominal bloating,especially lower abdominal distension occurs,they should seek medical treatment in time to avoid adnex-ectomy due to borderline tumors.

Giant massBorderline tumorClinical analysisOvary

柳华、凌静娴、朱湘虹、李荣、汤晓秋、张焱、周怀君

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南京大学医学院附属鼓楼医院妇产科,江苏 南京 210008

巨大包块 交界性肿瘤 临床分析 卵巢

2024

实用妇产科杂志
四川省医学会

实用妇产科杂志

CSTPCD北大核心
影响因子:2.564
ISSN:1003-6946
年,卷(期):2024.40(1)
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