2026 年第 7 期 第 21 卷

儿童和青少年卵巢扭转临床特征及手术治疗评估

Clinical characteristics and surgical treatment evaluation of ovarian torsion in children and adolescents

作者：游志恒石正峰赵正

英文作者：You Zhiheng Shi Zhengfeng Zhao Zheng

单位：山西省儿童医院普外科，太原030013

英文单位：Department of General Surgery Shanxi Children′s Hospital Taiyuan 030013 China

关键词：儿童、青少年；卵巢扭转；保留卵巢；腹腔镜

英文关键词：Childrenandadolescents;Ovariantorsion;Ovarianpreservation;Laparoscopy

• 摘要：

• 目的 探讨儿童、青少年卵巢扭转的临床特征及手术治疗，评估手术治疗的变化。方法 回顾性分析2017年1月至2024年12月在山西省儿童医院行手术治疗且明确诊断为卵巢扭转的儿童、青少年患者的临床特点、手术治疗情况及病理检查结果 。结果 本研究共纳入经手术确诊的儿童、青少年卵巢扭转158例，发病年龄频率呈双峰模式分布，高峰出现在婴儿期和月经初潮期。临床症状以腹痛、恶心、呕吐为主，分别占88.0%（139/158）、38.6%（61/158）、31.0%（49/158），新生儿多为产前检查发现腹部肿物，出生后手术确诊。超声检查为主要检查方式，151例行超声检查的患者术前诊断为卵巢扭转117例（77.5%）。腹腔镜应用比例由2017年27.3%（3/11）增长至2024年的87.0%（20/23），卵巢切除率由2017年的72.7%（8/11）下降至2024年的26.1%（6/23）。卵巢扭转合并肿物的病例类型多为良性病变。结论 儿童、青少年卵巢扭转中婴儿早期和青春期前后较为常见，临床症状无特异性，经腹盆腔超声是主要诊断方法 。儿童、青少年卵巢扭转中合并卵巢肿物更为多见，而卵巢扭转合并肿物的病理类型多为良性病变。儿童、青少年卵巢扭转术中卵巢切除率逐渐下降，而腹腔镜应用率近年维持较高的水平并保持稳定。

• Objective To explore the clinical characteristics and surgical treatment of ovarian torsion in children and adolescents, and to evaluate the changing trend of surgical strategies. Methods A retrospective analysis was performed on the clinical features, surgical modalities and pathological findings of children and adolescents with a confirmed diagnosis of ovarian torsion who underwent surgical treatment in Shanxi Children′s Hospital from January 2017 to December 2024. Results A total of 158 surgically confirmed cases of ovarian torsion in children and adolescents were enrolled. The age distribution presented a bimodal pattern, with peaks in infancy and menarche period. The main clinical manifestations included abdominal pain, nausea and vomiting, accounting for 88.0% (139/158), 38.6% (61/158) and 31.0% (49/158) respectively. Most neonatal cases were identified as abdominal masses during prenatal examination and confirmed surgically after birth. Ultrasound was the primary imaging modality; among 151 patients receiving ultrasound examination, 117 cases (77.5%) were preoperatively diagnosed with ovarian torsion. The application rate of laparoscopy increased from 27.3%(3/11) in 2017 to 87.0%(20/23) in 2024, while the oophorectomy rate decreased from 72.7%(8/11) in 2017 to 26.1%(6/23) in 2024. Most cases of ovarian torsion complicated with adnexal masses were of benign pathological types. Conclusion Ovarian torsion in children and adolescents is more common in early infancy and around puberty with non-specific clinical symptoms. Transabdominal and pelvic ultrasound serves as the main diagnostic method. Ovarian torsion combined with ovarian masses is frequently encountered in this population, and most associated masses are benign lesions. The intraoperative oophorectomy rate has gradually declined, while the application rate of laparoscopy has remained at a relatively high and stable level in recent years.