目的了解在北京大学深圳医院住院治疗的妊娠合并卵巢肿物患者的总体情况。方法对2012-2017年在北京大学深圳医院住院治疗的妊娠合并卵巢肿物患者的临床特征、诊治方法和妊娠结局进行回顾性分析。结果 6年间共有236例经手术病理证实为卵巢肿物,其中卵巢良性肿瘤占52.54%(123/236),交界性及恶性肿瘤占4.66%(11/236),瘤样病变占42.80%(101/236)。病理类型中以成熟型囊性畸胎瘤最多见,占24.15%(57/236),其次为卵巢黄体囊肿和卵巢子宫内膜异位囊肿,均为14.41%(34/236)。卵巢肿瘤蒂扭转是最常见的并发症,占5.51%(13/236),其中4例为成熟型囊性畸胎瘤,卵巢肿物破裂占1.27%(3/236),卵巢化脓性炎伴脓肿形成占0.42%(1/236),2例(0.85%,2/236)因孕中晚期压迫症状住院检查,均为卵巢交界性及恶性肿瘤。236例患者中足月妊娠203例,早产30例,治疗性人工流产2例。19例因下腹痛或腹胀等行剖腹探查者,8例同时行剖宫产终止妊娠,其中6例早产,无新生儿死亡,10例行附件切除或囊肿剥除术后继续妊娠,术后恢复良好,均足月分娩,母儿预后良好。结论妊娠合并卵巢肿物以良性为主,卵巢恶性肿瘤孕期难发现,妊娠前注意检查排除。

Objective The aim of this study was to describe the general characteristics of the ovarian tumor in pregnant women at Obstetrics department of Peking University Shenzhen Hospital. Methods A retrospective analysis focusing on clinical characters,diagnosis & treatment and pregnancy outcomes was performed among patients treated at Obstetrics department of Peking University Shenzhen Hospital between 2012-2017. Results A total of 236 cases of ovarian tumors were confirmed by surgery and pathology within 6 years,of which ovarian benign tumors accounted for 52. 54%(123/236),followed by tumor-like lesions(42. 80%,101/236) and borderline and malignant tumors(4. 66%,11/236). The most common pathological types were mature cystic teratomas,accounting for 24. 15%(57/236),followed by ovarian corpus luteum cysts and ovarian endometriotic cysts,which were 14. 41%(34/236). Ovarian tumor pedicle torsion was the most common complication,accounting for 5. 51%(13/236),of which 4 were mature cystic teratomas,1. 27%(3/236) of ovarian tumor ruptures,and 1 case of ovarian purulent inflammation with abscess formation,accounting for 0. 42%(1/236),2 cases of hospitalization due to compression symptoms in secondary or the third trimester pregnancy,accounting for 0. 85%(2/236),which were both borderline ovarian and malignant tumors. Of the 236 cases,203 cases were presented as term delivery,30 premature births,and 2 induced abortions. Of nineteen patients who underwent laparotomy for lower abdominal pain or abdominal distension,8 patients underwent cesarean section for termination of pregnancy. Six of them had premature delivery and there was no neonatal death. Ten patients underwent adnexectomy or cystectomy and continued pregnancy,and all of them were with a full-term delivery and a maternal-fetal prognosis. Conclusions Ovarian tumors of pregnant women are mainly benign. Ovarian malignant tumors are difficult to find during pregnancy and should be excluded before pregnancy.