天津医药

• 临床论丛 • 上一篇    下一篇

儿童卵巢扭转64例诊治体会

杨宏1,董亮2,董迎2,崔华雷2   

  1. 1. 天津儿童医院
    2. 天津市儿童医院
  • 收稿日期:2013-08-07 修回日期:2013-10-17 出版日期:2014-02-15 发布日期:2014-02-15
  • 通讯作者: 杨宏

  • Received:2013-08-07 Revised:2013-10-17 Published:2014-02-15 Online:2014-02-15
  • Contact: Hong YANG

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摘要： 【摘要】目的:总结儿童卵巢扭转的早期正确诊断和治疗方法。方法：回顾性分析我院2005年1月至2012年10月间收治的64例卵巢扭转病例，总结其临床表现，并结合B-超检查分析其早期诊断的主要征象。结果：本组中64例病人，7-12岁年龄段为高发年龄，患儿均表现有下腹部绞痛，彩色多普勒超声检查发现在盆腔有不均质肿块，提示早期有卵巢扭转可能。指肛检查检出率达到（45/64）70.3%。所有患者均行腹腔镜手术探查，5例切除卵巢，其余均保守治疗，分别在术后1、3、6月随访病人复查彩色多普勒超声患侧卵巢均与对侧大小一致。结论：儿童卵巢扭转较少见，无特殊临床表现，易致误诊。彩色多普勒超声和指肛检查对卵巢扭转的早期诊断有重要意义,同时积极进行腹腔镜手术探查也是诊断兼治疗的有效措施。

关键词: 卵巢扭转, 儿童, 囊肿, 畸胎瘤, 腹腔镜

Abstract: 【Abstract】 Objective: to evaluate the clinical features and key points in treatment of ovarian torsion in children. Methods: data of 64 children were analyzed retrospectively. Results: seven to twelve years old is the high incidence age of ovarian torsion. Most of the patients manifested typical lower abdominal cramps. unilateral non-homogeneoous mass in pelvic by color doppler ultrasound test often suggests ovarian torsion. All the patients underwent laparoscopic surgical exploration firstly. All but 5 cases with ovariectomy were treated conservatively successfully with normal size and function of ovarian. Conclusion: ovarian torsion in children is not commonly encountered clinically. Lacking of typical clinical manifestation, it is easily misdiagnosed. Once the diagnosis is identified, a surgical exploration is mandatory. The options of treatment to a twisted ovarian depends on ischemic time, extent of ischemia and characteristic of the leision.

Key words: Ovarian torsion, Children, Cyst, teratoma, laparoscope