摘要
目的探讨卵巢子宫内膜异位囊肿误诊为卵巢囊性畸胎瘤的原因,并总结防范措施。方法回顾分析我院2016年4月—2018年3月收治的误诊为卵巢囊性畸胎瘤的卵巢子宫内膜异位囊肿7例临床资料。结果本组3例因经期延长,经量增多1月余,经期感下腹疼痛就诊;3例因半个月前体检发现右下腹包块,1周前无明显诱因出现下腹胀痛、尿频,影响睡眠就诊;1例因半个月前感下腹胀痛、有压迫感,1周前体检发现卵巢肿物就诊。7例经妇科查体及超声检查,均初步诊断为卵巢囊性畸胎瘤,予择期手术治疗。4例术前完善腹部超声和(或)CT和(或)癌抗原125检查,考虑卵巢子宫内膜异位囊肿,予腹腔镜手术治疗,3例行手术探查,最终经病理检查确诊为卵巢子宫内膜异位囊肿,术后随访1年未见囊肿复发。结论卵巢子宫内膜异位囊肿患者缺乏特异性症状和体征,易误诊。当接诊不明原因下腹疼痛、盆腔包块、痛经、经量增多、经期紊乱的育龄期女性患者时,应考虑到卵巢子宫内膜异位囊肿可能,详细问诊,仔细查体,及时行相关检查甚至腹腔镜病理检查明确诊断,以减少或避免误诊的发生。
ObjectiveTo investigate the causes of misdiagnosis of ovarian endometriosis cyst (OEC) as ovarian cystic teratoma, and to summarize the preventive measures.MethodsThe clinical data of 7 patients with OEC misdiagnosed as ovarian cystic teratoma admitted to our hospital from April 2016 to March 2018 were retrospectively analyzed.ResultsThree patients suffered from lower abdominal pain due to prolonged menstruation and increased menstrual volume for more than one month.Three patients had right lower abdominal mass detected during physical examination half a month ago, and presented with unexplained lower abdominal pain and bloating or frequent urination which affected sleep one week ago.One patient suffered from lower abdominal pain and bloating half a month ago as well as sense of pressure, and ovarian tumors were found during physical examination one week ago.All 7 cases were diagnosed as ovarian cystic teratoma by gynecological examination and ultrasonography, and planned to undergo elective surgery.Abdominal ultrasonography and/or CT and/or CA125 were performed before operation in four patients, and OEC was considered.Therefore, laparoscopic surgery was performed.And three cases underwent surgical exploration, and the final diagnosis was OEC by pathological examination.No recurrence of OEC was found at 1-year follow-up.ConclusionOEC in patients lack specific symptoms and signs, which is, therefore, easily misdiagnosed.When female patients of childbearing age presented with unexplained lower abdominal pain, pelvic mass, dysmenorrhea, increased menstrual volume and menstrual disorders, the possibility of OEC should be considered.Detailed inquiry, careful physical examination, timely relevant examinations and even laparoscopy and pathological examination should be carried out to make a definite diagnosis, so as to reduce or avoid occurrence of misdiagnosis.
作者
黄萍
王滨
邵林
聂岩芳
曾健
HUANG Ping;WANG Bin;SHAO Lin;NIE Yan-fang;ZENG Jian(Department of Obstetrics and Gynecology,983Hospital of PLA,Joint Logistics Support Forces,Tianjin 300142,China)
出处
《临床误诊误治》
2019年第10期7-10,共4页
Clinical Misdiagnosis & Mistherapy
关键词
卵巢囊肿
误诊
畸胎瘤
Ovarian cysts
Misdiagnosis
Teratoma
