
Journal of International Obstetrics and Gynecology ›› 2022, Vol. 49 ›› Issue (3): 267-271.doi: 10.12280/gjfckx.20220251
• Research on Gynecological Malignancies:Review • Previous Articles Next Articles
SUN Lu, FAN Xiao-dong, LI Wen, YANG Yi-nan, ZHU Ying-jun(
)
Received:2022-04-07
Published:2022-06-15
Online:2022-06-23
Contact:
ZHU Ying-jun
E-mail:zhuyj8072@sina.com
SUN Lu, FAN Xiao-dong, LI Wen, YANG Yi-nan, ZHU Ying-jun. Clinical Analysis of 9 Adolescent Ovarian Endometriosis Recurrence Cases after Conservative Surgery[J]. Journal of International Obstetrics and Gynecology, 2022, 49(3): 267-271.
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| 病例 | 年龄(岁) | 婚育史 | 痛经(VAS评分,分) | 初次手术主诉 | CA125(U/mL) | CA19-9(U/mL) |
|---|---|---|---|---|---|---|
| 例1 | 20 | 已婚未育 | 0 | 发现盆腔肿物1个月 | 25.10 | 23.00 |
| 例2 | 19 | 未婚未育 | 7 | 慢性腹痛1个月 | 12.80 | 26.40 |
| 例3 | 20 | 已婚未育 | 7 | 右下腹痛8 d | 26.10 | 125.80 |
| 例4 | 20 | 未婚未育 | 7 | 发现盆腔肿物10 d | 20.31 | 141.70 |
| 例5 | 20 | 未婚未育 | 7 | 发现盆腔肿物9 d | 88.01 | 79.69 |
| 例6 | 20 | 未婚未育 | 10 | 发现盆腔肿物1个月 | 6.94 | 28.66 |
| 例7 | 21 | 已婚未育 | 7 | 发现盆腔肿物1个月 | 51.79 | 179.40 |
| 例8 | 21 | 已婚未育 | 8 | 发现盆腔肿物伴下腹痛3个月 | 9.65 | 38.40 |
| 例9 | 20 | 未婚未育 | 7 | 发现盆腔肿物2个月 | 77.74 | 83.81 |
| 病例 | 年龄(岁) | 婚育史 | 痛经(VAS评分,分) | 初次手术主诉 | CA125(U/mL) | CA19-9(U/mL) |
|---|---|---|---|---|---|---|
| 例1 | 20 | 已婚未育 | 0 | 发现盆腔肿物1个月 | 25.10 | 23.00 |
| 例2 | 19 | 未婚未育 | 7 | 慢性腹痛1个月 | 12.80 | 26.40 |
| 例3 | 20 | 已婚未育 | 7 | 右下腹痛8 d | 26.10 | 125.80 |
| 例4 | 20 | 未婚未育 | 7 | 发现盆腔肿物10 d | 20.31 | 141.70 |
| 例5 | 20 | 未婚未育 | 7 | 发现盆腔肿物9 d | 88.01 | 79.69 |
| 例6 | 20 | 未婚未育 | 10 | 发现盆腔肿物1个月 | 6.94 | 28.66 |
| 例7 | 21 | 已婚未育 | 7 | 发现盆腔肿物1个月 | 51.79 | 179.40 |
| 例8 | 21 | 已婚未育 | 8 | 发现盆腔肿物伴下腹痛3个月 | 9.65 | 38.40 |
| 例9 | 20 | 未婚未育 | 7 | 发现盆腔肿物2个月 | 77.74 | 83.81 |
| 病例 | 病灶位置 | ASRM分期 | 手术方式 | 术后治疗 |
|---|---|---|---|---|
| 例1 | 左侧卵巢子宫内膜异位囊肿6 cm,与周围组织粘连 | Ⅲ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 3个周期 |
| 例2 | 左侧卵巢子宫内膜异位囊肿5 cm | Ⅰ期 | 腹腔镜左侧卵巢囊肿剥除术 | GnRHa 2个周期 |
| 例3 | 右侧卵巢子宫内膜异位囊肿12 cm,左侧卵巢子宫内膜异位囊肿2 cm,直肠子宫陷凹封闭 | Ⅳ期 | 开腹双侧卵巢囊肿剥除术+盆腔粘连松解术+骶前神经切断术 | GnRHa 3个周期 |
| 例4 | 左侧卵巢子宫内膜异位囊肿6 cm,右侧卵巢子宫内膜异位囊肿2 cm,子宫腺肌病,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜双侧卵巢囊肿剥切术+盆腔粘连松解术 | GnRHa 6个周期 |
| 例5 | 左侧子宫内膜异位囊肿7 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 6个周期 |
| 例6 | 左侧子宫内膜异位囊肿3 cm,右侧子宫内膜异位囊肿6 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜双侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 3个周期 |
| 例7 | 左侧卵巢多房性子宫内膜异位囊肿7 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 6个周期 |
| 例8 | 左侧卵巢多房性子宫内膜异位囊肿8 cm,右侧子宫内膜异位囊肿3 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜双侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 3个周期 |
| 例9 | 左侧卵巢多房性子宫内膜异位囊肿6 cm,子宫腺肌病,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 4个周期 |
| 病例 | 病灶位置 | ASRM分期 | 手术方式 | 术后治疗 |
|---|---|---|---|---|
| 例1 | 左侧卵巢子宫内膜异位囊肿6 cm,与周围组织粘连 | Ⅲ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 3个周期 |
| 例2 | 左侧卵巢子宫内膜异位囊肿5 cm | Ⅰ期 | 腹腔镜左侧卵巢囊肿剥除术 | GnRHa 2个周期 |
| 例3 | 右侧卵巢子宫内膜异位囊肿12 cm,左侧卵巢子宫内膜异位囊肿2 cm,直肠子宫陷凹封闭 | Ⅳ期 | 开腹双侧卵巢囊肿剥除术+盆腔粘连松解术+骶前神经切断术 | GnRHa 3个周期 |
| 例4 | 左侧卵巢子宫内膜异位囊肿6 cm,右侧卵巢子宫内膜异位囊肿2 cm,子宫腺肌病,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜双侧卵巢囊肿剥切术+盆腔粘连松解术 | GnRHa 6个周期 |
| 例5 | 左侧子宫内膜异位囊肿7 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 6个周期 |
| 例6 | 左侧子宫内膜异位囊肿3 cm,右侧子宫内膜异位囊肿6 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜双侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 3个周期 |
| 例7 | 左侧卵巢多房性子宫内膜异位囊肿7 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 6个周期 |
| 例8 | 左侧卵巢多房性子宫内膜异位囊肿8 cm,右侧子宫内膜异位囊肿3 cm,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜双侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 3个周期 |
| 例9 | 左侧卵巢多房性子宫内膜异位囊肿6 cm,子宫腺肌病,直肠子宫陷凹封闭 | Ⅳ期 | 腹腔镜左侧卵巢囊肿剥除术+盆腔粘连松解术 | GnRHa 4个周期 |
| 病例 | 痛经复发 | 病灶复发 | 处理 | 目前情况 | 妊娠情况 |
|---|---|---|---|---|---|
| 例1 | 术前无痛经 | 术后1年右侧卵巢子宫内膜异位囊肿4 cm | 剖宫产术中行卵巢子宫内膜异位囊肿剥除术 | 未复发 | 术后7个月妊娠 |
| 例2 | 未复发 | 术后4年发现右侧卵巢子宫内膜异位囊肿复发 | 术后5年分娩后卵巢子宫内膜异位囊肿消失 | 未复发 | 术后5年妊娠 |
| 例3 | 术后7个月痛经复发 | 术后1年左侧卵巢子宫内膜异位囊肿5 cm,直肠子宫陷凹封闭 | 行卵巢子宫内膜异位囊肿剥除术+盆腔粘连松解术;术后4年右侧子宫内膜异位囊肿复发行囊肿穿刺术;术后6年左侧子宫内膜异位囊肿复发行囊肿穿刺术 | 复查见双侧卵巢子宫内膜异位囊肿4 cm | 未妊娠 |
| 例4 | 术后9个月痛经复发 | 术后6个月右侧子宫内膜异位囊肿2 cm | 患者要求观察;术后3年余双侧卵巢子宫内膜异位囊肿复发行囊肿穿刺术联合曼月乐治疗;术后5年因痛经、继发性贫血药物治疗无效行全子宫切除+直肠浆膜EMs病灶削切术 | 复查见右侧卵巢子宫内膜异位囊肿2 cm | 未妊娠 |
| 例5 | 术后9个月痛经复发 | 术后1年右侧卵巢子宫内膜异位囊肿4 cm | 患者要求观察;术后5年因双侧卵巢子宫内膜异位囊肿行囊肿穿刺术 | 复查见左侧卵巢子宫内膜异位囊肿4 cm | 未妊娠 |
| 例6 | 术后7个月复发 | 术后1年左侧子宫内膜异位囊肿8 cm,右侧子宫内膜异位囊肿3 cm,直肠子宫陷凹封闭 | 行双侧卵巢子宫内膜异位囊肿剥除术+盆腔粘连松解术 | 未复发 | 未妊娠 |
| 例7 | 术后9个月痛经复发 | 术后6个月左侧卵巢子宫内膜异位囊肿2 cm | 患者要求观察 | 复查见左侧卵巢子宫内膜异位囊肿4 cm | 未妊娠 |
| 例8 | 术后6个月痛经复发 | 术后3年右侧卵巢子宫内膜异位囊肿5 cm,直肠子宫陷凹封闭 | 行卵巢子宫内膜异位囊肿剥除术+盆腔粘连松解术 | 未复发 | 未妊娠 |
| 例9 | 术后7个月痛经复发 | 术后7个月左侧卵巢子宫内膜异位囊肿3 cm,直肠子宫陷凹封闭 | 口服孕激素2个月;术后2年因左侧卵巢子宫内膜异位囊肿6 cm行左侧附件切除术+盆腔粘连松解术 | 复查见右侧子宫内膜异位囊肿5 cm,中药治疗 | 未妊娠 |
| 病例 | 痛经复发 | 病灶复发 | 处理 | 目前情况 | 妊娠情况 |
|---|---|---|---|---|---|
| 例1 | 术前无痛经 | 术后1年右侧卵巢子宫内膜异位囊肿4 cm | 剖宫产术中行卵巢子宫内膜异位囊肿剥除术 | 未复发 | 术后7个月妊娠 |
| 例2 | 未复发 | 术后4年发现右侧卵巢子宫内膜异位囊肿复发 | 术后5年分娩后卵巢子宫内膜异位囊肿消失 | 未复发 | 术后5年妊娠 |
| 例3 | 术后7个月痛经复发 | 术后1年左侧卵巢子宫内膜异位囊肿5 cm,直肠子宫陷凹封闭 | 行卵巢子宫内膜异位囊肿剥除术+盆腔粘连松解术;术后4年右侧子宫内膜异位囊肿复发行囊肿穿刺术;术后6年左侧子宫内膜异位囊肿复发行囊肿穿刺术 | 复查见双侧卵巢子宫内膜异位囊肿4 cm | 未妊娠 |
| 例4 | 术后9个月痛经复发 | 术后6个月右侧子宫内膜异位囊肿2 cm | 患者要求观察;术后3年余双侧卵巢子宫内膜异位囊肿复发行囊肿穿刺术联合曼月乐治疗;术后5年因痛经、继发性贫血药物治疗无效行全子宫切除+直肠浆膜EMs病灶削切术 | 复查见右侧卵巢子宫内膜异位囊肿2 cm | 未妊娠 |
| 例5 | 术后9个月痛经复发 | 术后1年右侧卵巢子宫内膜异位囊肿4 cm | 患者要求观察;术后5年因双侧卵巢子宫内膜异位囊肿行囊肿穿刺术 | 复查见左侧卵巢子宫内膜异位囊肿4 cm | 未妊娠 |
| 例6 | 术后7个月复发 | 术后1年左侧子宫内膜异位囊肿8 cm,右侧子宫内膜异位囊肿3 cm,直肠子宫陷凹封闭 | 行双侧卵巢子宫内膜异位囊肿剥除术+盆腔粘连松解术 | 未复发 | 未妊娠 |
| 例7 | 术后9个月痛经复发 | 术后6个月左侧卵巢子宫内膜异位囊肿2 cm | 患者要求观察 | 复查见左侧卵巢子宫内膜异位囊肿4 cm | 未妊娠 |
| 例8 | 术后6个月痛经复发 | 术后3年右侧卵巢子宫内膜异位囊肿5 cm,直肠子宫陷凹封闭 | 行卵巢子宫内膜异位囊肿剥除术+盆腔粘连松解术 | 未复发 | 未妊娠 |
| 例9 | 术后7个月痛经复发 | 术后7个月左侧卵巢子宫内膜异位囊肿3 cm,直肠子宫陷凹封闭 | 口服孕激素2个月;术后2年因左侧卵巢子宫内膜异位囊肿6 cm行左侧附件切除术+盆腔粘连松解术 | 复查见右侧子宫内膜异位囊肿5 cm,中药治疗 | 未妊娠 |
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doi: 10.1016/j.ejogrb.2016.05.008 pmid: 27240262 |
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