摘要
目的探讨妊娠合并卵巢恶性肿瘤的临床特点、诊疗方案及临床结局。方法回顾性分析2005年10月至2018年12月大连医科大学附属大连市妇产医院暨大连市妇幼保健院等5所医院收治的11例妊娠合并卵巢恶性肿瘤患者的临床资料。结果妊娠合并卵巢恶性肿瘤的发生率为0.05‰(11/241770)。11例患者中,7例为卵巢原发性恶性肿瘤,其中手术未分期1例、Ⅰ期5例、ⅢC期1例。7例卵巢原发性恶性肿瘤患者中,1例ⅢC期患者放弃妊娠,另6例患者均选择保证胎儿存活的前提下终止妊娠。11例患者中,4例为转移性肿瘤,其中3例手术治疗,均要求保胎放弃恶性肿瘤治疗。11例患者共获得9例新生儿,早产儿4例,其中1例于出生后5min死亡,余8例新生儿均健康存活。结论妊娠合并卵巢恶性肿瘤部分缺乏特异性临床症状,联合各项辅助检查有助于诊断,术中冰冻病理、术后石蜡病理可明确诊断及分期,应警惕转移性肿瘤可能;治疗应根据诊断时的妊娠状态、肿瘤病理类型和分期、患者及家属意愿制定个体化方案。
Objective To analyze the clinical features,diagnosis and treatment plan and clinical outcomes of pregnancy with ovarian cancer.Methods Retrospectively analyze the clinical data of 11 pregnant women with ovarian cancer admitted to five hospitals in Dalian from October 2005 to December 2018.Results The incidence of pregnancy with ovarian cancer was 0.05‰(11/241770).Among 11 cases of pregnancy with ovarian cancer,7 cases were primary malignant ovarian tumors,of which there was one case without staging during operation,5 cases of stageⅠ,and 1 case of stageⅢC.The except stageⅢC patient gave up pregnancy,while the other 6 patients chose to terminate pregnancy on the premise of ensuring the survival of the fetus.Four cases were ovarian metastatic tumors,of which 3 were surgically treated,and all4 patients required to retain the fetus and abandon the treatment for malignant tumors.There were 9 neonates,including 4 premature infants,of whom,1 case died 5 minutes after birth and the remaining 8 neonates were healthy.Conclusion The pregnancy with ovarian cancer lacks typical clinical symptoms;the combination of multiple auxiliary examinations is of great significance in the diagnosis of diseases.Diagnosis and staging can be determined according to the intraoperative and postoperative pathological results.We should be alert to metastatic tumors.The individualized treatment plan of the disease should be based on the pregnancy status,the type of tumor pathology and the stage of the tumor,the wishes of the patient and the family.
作者
王春阳
高景春
金仙玉
王惠华
周慧
韩璐
WANG Chun-yang;GAO Jing-chun;JIN Xian-yu;WANG Hui-hua;ZHOU Hui;HAN Lu(Department of Gynecology,Dalian Obstetrics and Gynecology Hospital Affiliated to Dalian Medical University,Dalian 116033,China;不详)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2019年第12期1354-1359,共6页
Chinese Journal of Practical Gynecology and Obstetrics
作者简介
通讯作者:韩璐,电子信箱:13940801858@163.com.
