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附件扭转的临床特征及保留卵巢手术的作用:一项临床回顾性分析。

Clinical characteristics of adnexal torsion and role of ovarian sparing surgery: a clinical retrospective analysis.

机构信息

Department of Gynaecology, Affiliated Weihai Municipal Hospital, Shandong University, Weihai, China, China.

出版信息

Ginekol Pol. 2024;95(2):84-91. doi: 10.5603/gpl.95324. Epub 2023 Oct 20.

Abstract

OBJECTIVES

To analyze the clinical characteristics and risk factors related to necrosis of adnexal torsion (AT) and improve the application of ovarian-sparing surgery (OSS).

MATERIAL AND METHODS

Data of 142 patients with 144 surgically confirmed AT lesions between October 2011 and December 2021 were retrospectively analyzed.

RESULTS

The risk of torsion caused by tumors was higher than that caused by tumor-like lesions (p = 0.003). The incidence of right adnexal necrosis was higher than that of left adnexal necrosis (p = 0.03). There were no significant differences in adnexal necrosis or onset time (p = 0.29) between groups. The main risk factor for adnexal necrosis was the degree of torsion with a threshold of 510°. The size of adnexal mass and the degree of torsion increased linearly with age. The OSS rate was 59.7% for all patients, and 71.6% in the premenopausal women. No serious complications occurred in any of the patients.

CONCLUSIONS

Age, histopathological type, adnexal size, degree of torsion, and pelvic anatomical structure are risk factors for AT and adnexal necrosis. There is no infinite correlation between adnexal necrosis and onset time. Adnexal size is the main risk factor for AT, and along with the risk of adnexal necrosis, increases with age. The degree of torsion is the main risk factor for adnexal necrosis, and torsional severity increases with age. OSS is safe and does not increase the incidence of postoperative complications.

摘要

目的

分析附件扭转(AT)相关的坏死的临床特征和危险因素,提高保留卵巢手术(OSS)的应用。

材料和方法

回顾性分析 2011 年 10 月至 2021 年 12 月间 142 例经手术证实的 144 例 AT 病变患者的数据。

结果

肿瘤引起扭转的风险高于肿瘤样病变(p = 0.003)。右侧附件坏死的发生率高于左侧附件坏死(p = 0.03)。附件坏死或发病时间在两组之间无显著差异(p = 0.29)。附件坏死的主要危险因素是扭转程度,阈值为 510°。附件肿块的大小和扭转程度随年龄呈线性增加。所有患者的 OSS 率为 59.7%,绝经前妇女为 71.6%。所有患者均未发生严重并发症。

结论

年龄、组织病理学类型、附件大小、扭转程度和盆腔解剖结构是 AT 和附件坏死的危险因素。附件坏死与发病时间之间没有无限的相关性。附件大小是 AT 的主要危险因素,随着附件坏死的风险增加,与年龄呈正相关。扭转程度是附件坏死的主要危险因素,扭转严重程度随年龄增加而增加。OSS 是安全的,不会增加术后并发症的发生率。

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