摘要
目的:探讨妊娠期与非妊娠期附件扭转(adnexal torsion,AT)患者的临床和病理特点差异。方法:回顾性分析2017年1月—2023年11月在北京大学第三医院妇产科住院手术治疗的376例AT患者的临床资料,其中妊娠期AT组72例,非妊娠期AT组304例,根据孕周妊娠期AT患者进一步分为妊娠早期AT组(≤14周,n=47)和妊娠中晚期AT组(>14周,n=25)。分析并比较2组患者的临床资料。结果:①妊娠期AT组呕吐、下腹痛时间<24 h及持续性腹痛的比例、白细胞计数、中性粒细胞比例明显高于非妊娠期AT组(均P<0.05)。②妊娠期AT组行手术路径(开腹手术者比例)和手术方式(保守性手术者比例)以及术后病理为黄体囊肿的比例明显高于非妊娠期AT组,附件区包块的直径、术后病理为成熟性畸胎瘤、黏液性囊腺瘤和子宫内膜异位囊肿的比例明显低于非妊娠期AT组(均P<0.05)。③妊娠早期AT组辅助生殖技术助孕、腹腔镜手术和保守性手术的比例、附件区包块直径明显高于妊娠中晚期AT组,病理性囊肿的比例和扭转度数明显低于妊娠中晚期AT组(均P<0.05)。结论:妊娠期如出现下腹痛、恶心呕吐等表现,需警惕AT,尤其是妊娠早期、辅助生殖技术助孕后,病理多为黄体囊肿。妊娠期治疗AT,无论腹腔镜还是开腹手术,都是安全可靠的,且不影响妊娠结局。
Objective:To investigate the clinical and pathological differences between pregnant and non-pregnant women with adnexal torsion(AT).Methods:A retrospective analysis was conducted on the clinical data of 376 AT patients who were hospitalized in the Department of Obstetrics and Gynecology,Peking University Third Hospital from January 2017 to November 2023,including 72 pregnant women with AT and 304 non-pregnant women with AT.Based on gestational weeks,pregnant women with AT were divided into the first trimester group(≤14 weeks)with 47 cases and the second and third trimester group(>14 weeks)with 25 cases.A comparative analysis of the clinical data between these groups was performed.Results:①The proportion of vomiting,abdominal pain time<24 hours,persistent abdominal pain,the count of white blood cell and the percentage of neutrophil in pregnant women with AT were significantly higher than those in non-pregnant women with AT(P<0.05).②The rates of laparotomy,conservative surgery and postoperative pathology of luteal cyst in pregnant women with AT were significantly higher than those in non-pregnant women with AT(P<0.05).The diameter of adnexal mass,the proportion of mature teratoma,mucinous cystadenoma and endometriosis cyst by postoperative pathology in pregnant women with AT were significantly lower than those in non-pregnant women with AT(P<0.05).③Compared to the second and third trimester AT group,in the first trimester AT group,the proportion of assisted reproductive technology,laparoscopic surgery and conservative surgery,and the diameter of adnexal mass were higher,the proportion of pathological cysts and the degree of torsion were significantly lower(P<0.05).Conclusions:The presence of symptoms such as lower abdominal pain,nausea and vomiting during pregnancy necessitates consideration of AT,especially in early pregnancy or following assisted reproductive technology,the pathology is often corpus luteum cysts.The treatment of AT during pregnancy,whether laparoscopic or open surgery,is safe and reliable,without adversely impacting pregnancy outcomes.
作者
邵珲
郭晓玥
张华
赵扬玉
SHAO Hui;GUO Xiao-yue;ZHANG Hua;ZHAO Yang-yu(Department of Obstetrics and Gynecology,National Clinical Research Center for Obstetrics and Gynecology,National Center for Healthcare Quality Management in Obstetrics,Peking University Third Hospital,Beijing 100191,China;Clinical Epidemiology Research Center,Peking University Third Hospital,Beijing 100191,China)
出处
《国际妇产科学杂志》
CAS
2024年第3期336-341,共6页
Journal of International Obstetrics and Gynecology
基金
国家重点研发计划重点专项(2021YFC2701500)。
关键词
卵巢扭转
妊娠
外科手术
腹腔镜检查
疾病特征
病理状态
解剖学
Ovarian torsion
Pregnancy
Surgical procedures,operative
Laparoscopy
Disease attributes
Pathological conditions,anatomical
