摘要
目的探讨胎儿/3月龄内婴儿卵巢囊肿产前、生后治疗策略及预后。方法回顾性分析2013年12月至2023年12月华中科技大学同济医学院附属武汉儿童医院收治的94例胎儿/3月龄内婴儿卵巢囊肿病例的临床资料,包括产前及生后影像资料、治疗方式、预后,根据囊肿大小分为直径<3 cm(44例)、3~4 cm(19例)和≥4 cm组(31例),通过χ2检验比较各组的复杂型囊肿比例及卵巢坏死率。结果94例病例中单纯型囊肿62例,复杂型囊肿32例(其中2例宫内首次诊断时为单纯型囊肿,后宫内转变为复杂型囊肿);产前诊断67例(52例单纯型囊肿,15例复杂型囊肿),均未行宫内干预,另27例为生后发现(10例单纯型囊肿,17例复杂型囊肿)。93.8%(30/32)的复杂型囊肿发生卵巢坏死。囊肿直径3~4 cm组和≥4 cm组中复杂型囊肿的比例均高于直径<3 cm组[12/19和48.3%(15/31)与11.4%(5/44),χ2值分别为15.53和10.92,P值均<0.001],卵巢坏死率也均高于直径<3 cm组[12/19和45.2%(14/31)与9.1%(4/44),χ2值分别为17.72和11.07,P值均<0.001]。囊肿直径3~4 cm组与≥4 cm组复杂型囊肿的比例和卵巢坏死率差异均无统计学意义(P值均>0.05)。结论对于胎儿/3月龄内婴儿卵巢囊肿的生后治疗,单纯型囊肿直径≥4 cm时建议手术治疗,直径3~4 cm时卵巢坏死率较高,需严密随访;对于复杂型卵巢囊肿,建议积极手术治疗。
Objective:To evaluate prenatal and postnatal management strategies for ovarian cysts in fetuses and infants within three months.Methods:This retrospective analysis included 94 cases managed at Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology(December 2013 to December 2023)with prenatal/postnatal imaging,management,and outcomes data.Cysts were stratified by diameter:<3 cm(n=44),3-4 cm(n=19),and≥4 cm(n=31).Proportions of complex cysts and ovarian necrosis rates were compared using Chi-square tests.Results:Among 94 cases,62 were simple ovarian cysts and 32 complex(including two initially simple cysts that converted to complex in utero).Prenatal diagnosis occurred in 67 cases(52 simple,15 complex)without intrauterine intervention and 27 were postnatally detected(10 simple,17 complex).Ovarian necrosis affected 93.8%(30/32)of complex cysts.Both 3-4 cm and≥4 cm groups demonstrated significantly higher complex cyst rates[12/19 and 48.3%(15/31)vs.11.4%(5/44),χ2=15.53 and 10.92,both P<0.001]and ovarian necrosis frequencies[12/19 and 45.2%(14/31)vs.9.1%(4/44),χ2=17.72 and 11.07,both P<0.001]compared to the<3 cm group,whereas no significant differences existed between 3-4 cm and≥4 cm groups(both P>0.05).Conclusion:For postnatal management,surgical intervention is recommended for complex ovarian cysts in fetuses and infants within three months of age.For simple cysts≥4 cm,surgery is advised,while those measuring 3-4 cm warrant close monitoring due to elevated necrosis risk.
作者
蔡源
孙润物
鲁巍
余雷
桂琳玲
Cai Yuan;Sun Runwu;Lu Wei;Yu Lei;Gui Linling(Department of Neonatal Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430016,China)
出处
《中华围产医学杂志》
北大核心
2025年第8期633-637,共5页
Chinese Journal of Perinatal Medicine
