【摘要】 目的了解治疗腹痛伴附件包块患儿适当的处理方式。方法回顾性分析1999年4月～至2006年7月因腹痛伴附件包块行腹腔镜手术或腹式手术的30例患儿(年龄≤14岁)的临床资料。结果平均年龄11.36岁(7～14岁)。腹腔镜手术组18例,腹式手术组12例。腹腔镜组患侧附件切除7例,患侧卵巢囊肿剥除5例,患侧输卵管切除4例,阑尾切除+单侧附件切除1例,卵巢肿瘤活检+阑尾切除1例+单侧附件1例;腹式组患侧附件切除7例,患侧卵巢囊肿剥除4例,患侧附件切除+大网膜切除+阑尾切除1例。腹腔镜组病理类型成熟性畸胎瘤10例(10/18,其中出血梗死5例);卵巢及输卵管出血性梗死性质不能确定,已彻底坏死7例;卵巢无性细胞瘤1例。腹式组成熟性畸胎瘤7例(7/12,其中出血梗死3例),卵巢浆液性囊腺瘤3例,卵巢未成熟性畸胎瘤和内胚窦瘤各1例。手术均顺利进行,无1例发生手术和麻醉并发症。术后随访无1例再次出现附件包块,不影响患儿月经。行卵巢囊肿剥除术的患儿入院到手术日时间短于行附件切除/输卵管切除的患儿,明显腹痛者卵巢囊肿剥除组小于切除组。结论积极手术处理对保留患儿卵巢、输卵管是非常重要的,腹腔镜手术治疗儿童腹痛伴附件包块是安全和可行的。更多还原

【Abstract】 Objective To observe appropriate treatment in abdominal pain with adnexal masses inchildren. Methods Clinical data of 30 children (below 14 year of age ) with abdominal pain and adnexalmasses had been explorated by laparosopy or abdominally between April 1994 and 2006 were reviewed.Results The mean age was 11.36 years (range ,7-14 years). The laparosopy group was 18 cases ,thelaparotome group was 12 cases. Among the laparosopy group , 7 cases were unilateral adnexectomy , 5cases were ovarian cystectomy , 4 cases were unilateral salpingectomy, 1 cases was both unilateraladnexectomy and appendectomy, and 1 case was both unilateral adnexectomy and appendectomy after ovarychecked. Among the laparotome group , 7 cases were unilateral adnexectomy, 4 cases were ovariancystectomy and 1 case unilateral adnexectomy, appendectomy and epiploonectomy . Among the types ofpathology in the laparosopy group, 10 cases were mature teratoma (6 cases in hemorrhage and infaret),7 cases were hemorrhage and necrosis tissue and 1 case were ovarian dysgerminoma. Among the types ofpathology in the lapardenoma, 1 case unmature teratom and 1 case yolk sac tumor . All operations weresuccessful and had no complication of operation and anesthesia . The time from inhospital to operationin cases of ovarian cystectomy group was shorter than that in adnexectomy group . The number of caseof severe abdomen pain in ovarian cystectomy was smaller than that in adnexectomy group. Nodbodyrelapsed and the operation has no effect on children menstruation after follow-up . ConclusionActively operational treatment is very important to save ovary and oviduct in children . Laparosopymay be safely used in children with abdominal pain and adnexal masses.更多还原