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卵巢巧克力囊肿破裂致急腹症37例分析 |
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邵丽娜 王维恭
摘要 对37例经开腹手术和病理结果证实为卵巢巧克力囊肿破裂的病例进行分析。本病发病呈上升趋势，误诊率高，本文结果显示术前确诊16例，确诊率为43.2%。本病特点为月经期或月经周期后半期发生突发性下腹剧痛伴明显腹膜刺激症，后穹隆穿刺抽出咖啡色液体，且无闭经、阴道不规则出血及休克体征。 21例分别误诊为卵巢囊肿蒂扭转，黄体破裂，异位妊娠和急性阑尾炎，其中阑尾炎占8例，提示本症需与上述妇科急腹症和急性阑尾炎鉴别。
关键词 卵巢巧克力囊肿 破裂 急腹症
Acute abdomen resulted from ruptured ovarian“chocolate”
cyst:an analysis of 37 cases
Shao Lina, Wang Weigong
(Dept.of Obstetrics and Gynecology, Beijing TongRen Hospital, Beijing 100730)
Abstract Thirty seven of cases with an acute abdomen resulted from ruptured ovarian “chocolate” cyst were studied. The final diagnoses for all 37 cases were proved by the abdominal operations and final pathological reports. An incidence of the disease tends to increase, however, it is difficult to make a correct diagnosis before surgery. The result in this study showed that 16 cases arrived at correct diagnosis, a correct rate of 43.2% was obtained. The woman with an ruptured ovarian“chocolate”cyst occurring in menses or in the latter half of cycle may present as a sudden and persistent severe lower abdominal pain with significant peritoneal irritation, but without a history of a missed period followed by irregular vaginal bleeding and not in shock. Obtaining fluid like coffee as a positive result of puncture of the posterior fornix is strongly suggestive of a ruptured “chocolate”cyst. The wrong diagnoses were made in 21 of cases as ovarian cyst turned on its stalk, ruptured corpus luteum cyst, ectopic pregnancy and acute appendicitis, 8 cases of them were appendicitis. The result suggested that it is necessary to distinguish the disease from an acute abdomen mentioned above, especially from an acute appendicitis.
Key words Ovarian “chocolate” cyst Ruptured Acute abdomen
随着子宫内膜异位症发病率的增加，卵巢巧克力囊肿破裂的发病率随之增多［1］，并已成为并非罕见和不容忽视的妇科急腹症。国外对此病报道较早［2，3］，国内自80年代开始已逐渐认识本症。我们选取37例卵巢巧克力囊肿破裂所致急腹症的病例，旨在[1] [2] 下一页
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