幼女卵巢扭转腹腔镜下卵巢动静脉结扎后复位手术10例临床分析
[摘要] 目的 探讨幼女卵巢扭转后的最佳处理方式。 方法 对珠海市妇幼保健院妇科2004年1月～2011年6月行腹腔镜下诊断卵巢扭转并进行卵巢动静脉结扎后复位，保留患侧卵巢的10例患者进行回顾性分析，术后监测发热、血栓等并发症的发生，术后1、3个月通过B超、性激素测定观察保留卵巢的功能恢复情况。 结果10例卵巢扭转患者手术复位均成功，平均住院时间(5.34±2.16) d，术后发热2例，对症处理后退热，术后随访1～3个月，1例失访，B超检查8例显示卵巢动、静脉血流信号正常，1例术后3个月B超发现卵巢缩小。 结论 幼女卵巢扭转进行腹腔镜下卵巢动静脉结扎后复位术，能有效预防血栓脱落，保留患侧卵巢功能，对幼女的生育功能保留及生长、发育起关键作用。
[关键词] 幼女；卵巢扭转；腹腔镜；卵巢动静脉结扎后复位术
[中图分类号] R729 [文献标识码] A [文章编号] 1674-4721(2012)07(c)-0077-02
Clinical analysis of young female with ovarian torsion treated by reposition after ovarian artery and vein ligation under laparoscopic in 10 cases
LUO Fen XIE Fengyun LIANG Huiqing
Department of Gynaecology, the Maternal and Child Health Hospital of Zhuhai City in Guangdong Province, Zhuhai 519000, China
[Abstact] Objective To explore the best way for the young female after ovarian torsion. Methods Ten cases of patients who underwent gynaecological laparoscopic diagnosis of ovarian torsion and reposition after ovarian artery and vein ligation to retain ipsilateral ovarian in the maternal and child health hospital of Zhuhai from January 2004 to June 2011 were retrospectively analyzed. Complications such as heating, thrombotic in postoperative were monitored, after surgery for 1, 3 months, reserved ovarian function restoration was deternined by B ultrasound and sex hormone assay. Results Ten cases of patients with ovarian torsion treated by reposition operation were all successful. The mean hospital stay was (5.34±2.16) d, postoperative fever was found in 2 cases, and they were defervescence after symptomatic treatment, patients were followed up for 1-3 months, 1 case was lost to follow-up, 8 cases showed ovarian and vein normal flow signals by B ultrasonic examination, and 1 case was found ovarian narrowing by B ultrasonic after surgery for 3 months. Conclusion Young female with ovarian torsion treated by reposition after ovarian artery and vein ligation under laparoscopic, can effectively prevent blood clots fall off, keep a side of ovarian function, and plays a key role for young female to retain the function of reproductive, growth and development.
[Key words] Young female; Ovarian torsion; Laparoscopic; Ovarian artery and vein ligation after reposition
幼女卵巢扭转是临床较为少见的急腹症，由于症状不典型而易误诊[1]。传统观点认为卵巢蒂扭转后于卵巢静脉形成血栓，应手术将扭转的卵巢和蒂一并切除，不可复位，防止形成的栓子脱落，随血循环栓塞其他脏器。卵巢作为女性的性腺器官，行卵巢切除后，可能影响幼女的生长、发育，甚至影响以后的生育功能。本院2004～2011年对10例患儿采取腹腔镜下卵巢动静脉结扎后复位术，有效地保留了患儿的卵巢功能，减少了患儿的创伤。
1 资料与方法
1.1 一般资料
2004年1月～2011年6月腹腔镜下诊断卵巢扭转变色患儿共10例。其中有典型腹痛、恶心、呕吐症状的患儿6例，仅下腹坠胀、发热患儿4例。病程2 h～半个月不等，其中1例为半个月，其余为2 h～5 d。, 百拇医药(罗芬 谢凤云 梁慧清)
[关键词] 幼女；卵巢扭转；腹腔镜；卵巢动静脉结扎后复位术
[中图分类号] R729 [文献标识码] A [文章编号] 1674-4721(2012)07(c)-0077-02
Clinical analysis of young female with ovarian torsion treated by reposition after ovarian artery and vein ligation under laparoscopic in 10 cases
LUO Fen XIE Fengyun LIANG Huiqing
Department of Gynaecology, the Maternal and Child Health Hospital of Zhuhai City in Guangdong Province, Zhuhai 519000, China
[Abstact] Objective To explore the best way for the young female after ovarian torsion. Methods Ten cases of patients who underwent gynaecological laparoscopic diagnosis of ovarian torsion and reposition after ovarian artery and vein ligation to retain ipsilateral ovarian in the maternal and child health hospital of Zhuhai from January 2004 to June 2011 were retrospectively analyzed. Complications such as heating, thrombotic in postoperative were monitored, after surgery for 1, 3 months, reserved ovarian function restoration was deternined by B ultrasound and sex hormone assay. Results Ten cases of patients with ovarian torsion treated by reposition operation were all successful. The mean hospital stay was (5.34±2.16) d, postoperative fever was found in 2 cases, and they were defervescence after symptomatic treatment, patients were followed up for 1-3 months, 1 case was lost to follow-up, 8 cases showed ovarian and vein normal flow signals by B ultrasonic examination, and 1 case was found ovarian narrowing by B ultrasonic after surgery for 3 months. Conclusion Young female with ovarian torsion treated by reposition after ovarian artery and vein ligation under laparoscopic, can effectively prevent blood clots fall off, keep a side of ovarian function, and plays a key role for young female to retain the function of reproductive, growth and development.
[Key words] Young female; Ovarian torsion; Laparoscopic; Ovarian artery and vein ligation after reposition
幼女卵巢扭转是临床较为少见的急腹症，由于症状不典型而易误诊[1]。传统观点认为卵巢蒂扭转后于卵巢静脉形成血栓，应手术将扭转的卵巢和蒂一并切除，不可复位，防止形成的栓子脱落，随血循环栓塞其他脏器。卵巢作为女性的性腺器官，行卵巢切除后，可能影响幼女的生长、发育，甚至影响以后的生育功能。本院2004～2011年对10例患儿采取腹腔镜下卵巢动静脉结扎后复位术，有效地保留了患儿的卵巢功能，减少了患儿的创伤。
1 资料与方法
1.1 一般资料
2004年1月～2011年6月腹腔镜下诊断卵巢扭转变色患儿共10例。其中有典型腹痛、恶心、呕吐症状的患儿6例，仅下腹坠胀、发热患儿4例。病程2 h～半个月不等，其中1例为半个月，其余为2 h～5 d。, 百拇医药(罗芬 谢凤云 梁慧清)