腹腔镜检�?/title> <meta name="keywords" content="<a href='/List.aspx?chid=21&Keyword=%e8%85%b9%e8%85%94%e9%95%9c&FieldName=tagnamestr' target='_blank'>腹腔�?/a> <a href='/List.aspx?chid=21&Keyword=%e6%a3%80%e6%9f%a5&FieldName=tagnamestr' target='_blank'>检�?/a>,腹腔镜检�?盆腔检�? /> <meta name="description" content=" 腹腔镜检查可清楚地观察到盆腔组织结构及卵巢肿瘤的外观性状，这对诊断及治疗卵巢疾病意义重大。特别是在决定对卵巢进行何种手术时，如是作肿瘤剔除、卵巢切除还是保留卵巢，对肿瘤性质的判断非常重要。但卵巢肿瘤性质的确定有时很困难，甚至病理学家也会对同一张切片有争议�? /> <link href="http://images.whrenai.com/news_images/new_css.css" rel="stylesheet" type="text/css"> <SCRIPT src="http://images.whrenai.com/by_images/showFlash.js"></SCRIPT> <script type="text/javascript" language="javascript" src="http://images.whrenai.com/js/copy.js "></script> <SCRIPT src="http://images.whrenai.com/by_images/showFlash.js"></SCRIPT> <script language="javascript" src="http://images.whrenai.com/zx.js"></script> <script language='javascript' src='/js/Page.js'></script> <script language='javascript' src='/js/Xmlhttp.js'></script> <script 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href='/Baojian/pqjc/Index.html'>盆腔检�?/a> > 内容阅读</div>  <div class=bt><h1>腹腔镜检�?/h1></div>  <div class=time>08-02-02 15:26:52　　　　　　</div>  <div class=key>关键词：<a href='/List.aspx?chid=21&Keyword=%e8%85%b9%e8%85%94%e9%95%9c&FieldName=tagnamestr' target='_blank'>腹腔�?/a> <a href='/List.aspx?chid=21&Keyword=%e6%a3%80%e6%9f%a5&FieldName=tagnamestr' target='_blank'>检�?/a></div>  <div class=daodu>腹腔镜检查可清楚地观察到盆腔组织结构及卵巢肿瘤的外观性状，这对诊断及治疗卵巢疾病意义重大。特别是在决定对卵巢进行何种手术时，如是作肿瘤剔除、卵巢切除还是保留卵巢，对肿瘤性质的判断非常重要。但卵巢肿瘤性质的确定有时很困难，甚至病理学家也会对同一张切片有争议�?/div>  <div class=geyan><label><span>健康谚语</span></label></div>  <div class=concent fang=08-02-02 15:26:52> <p>术中送冷冻切片具有病理学意义，但妇科医生或术者应该有对大体标本进行初步判断的能力。可根据卵巢肿瘤的形态、房腔、切面颜色、囊实性等形态做出估计，进而指导手术方案的初步制定�?/p> <p>1．瘤体特点根据瘤体形状，可初步判断卵巢肿瘤性质。北京协和医院郎景和教授根据多年的临床经验，对卵巢肿瘤的大体形状与肿瘤性质之间的关系进行了细致的观察和总结：①单房、壁薄、囊内液无色或草黄色清亮，多考虑为单纯囊肿、浆液性囊腺瘤。②多房、充满黏液、见于黏液性囊腺瘤；有内生或外生乳头是浆液性或黏液性囊腺瘤或囊腺癌。③部分为实性、伴出血、坏死，应警惕子宫内膜样癌、透明细胞癌。④切面色泽：红色，有出血、坏死，要考虑内胚窦瘤；黄色实性，见卵泡膜细胞瘤；白色实性，见于纤维上皮瘤、纤维瘤，卵巢纤维瘤可坚硬如石，为卵巢肿瘤实硬之最；灰红、棕黄、橡皮样要考虑无性细胞瘤。⑤双侧、肾形、实性半透明胶状是转移性癌的特点。⑥巧克力汁样内液是最富有特点的子宫内膜异位囊肿的内容物，但铁锈色、稀薄的液体可能是陈旧性出血，不一定是巧克力囊肿�?/p> <p><br /> 通过对卵巢肿瘤的大体性状进行观察，做出初步判断，可为术中处理提供参考�?/p> <p> <br /> 2．腹腔镜处理附件肿物注意事项</p> <p><br /> (1)检查盆腔和腹部有无肿瘤种植，肿物部位有无大量肠粘连，或腹膜有无赘生物�?(2)在开始切除前收集冲洗液，特别是对绝经后病人�?/p> <p>(3)尽量减少肿物内容物溢出，争取完整切除囊肿�?/p> <p>(4)如囊肿被切开，应检查内层上皮�?/p> <p>(5)如囊肿显示有功能，或不能切除时，应取囊壁做活组织检查�?/p> <p>(6)应将囊肿剥出或切除而不引流�?/p> <p>(7)诊断可疑时，取组织做冷冻切片检查�?/p> <p><br /> 3．腹腔镜在卵巢恶性肿瘤中的作用腹腔镜虽在治疗卵巢恶性肿瘤中的作用存在争议，但对其诊断价值及判定治疗效果时的作用不容争辩�?腹腔镜对卵巢恶性肿瘤的作用可概括为以下几个方面�?/p> <p><br /> (1)临床可疑卵巢癌的确诊：腹腔镜属微创诊治工具，虽不能作为诊断早期卵巢癌的普查方法，但对临床疑为卵巢癌的盆腔包块，或对某些盆腔包块性质不明需做鉴别诊断时，腹腔镜检查很有诊断价值�?/p> <p><br /> (2)有助于制订卵巢癌合理的治疗方案：通过腹腔镜检查可按病变性质及范围决定有无手术可能，对制订手术方式、手术前后处理方案及提示疾病预后等，均有很大的参考价值�?/p> <p> <br /> (3)有助于卵巢癌的临床分期：因腹腔镜可全面清晰地观察盆腹腔状况，甚至优于手术探查�?/p> <p><br /> (4)在卵巢癌随诊中的作用：卵巢癌虽然手术切净，或手术不彻底术后追加化疗或放疗，但复发率仍高。因此，术后二探术很有必要，采用腹腔镜进行二探具有微创效果，是卵巢癌二探术的首选方法�?br /> </p> <p>腹腔镜二探术(second—look laparosco—py)适用于以下几种情况：①随访晚期交界性肿瘤患者，需经腹腔镜活检确定肿瘤生物学行为进展抑或退化。②监护卵巢癌I�?�?级患者手术后未接受辅助治疗的情况，或I期囊肿破裂手术后的情况。③用于化疗期间，经腹腔镜检查观察化疗结果�?/p> </div>  <div class=next> <p><a href="/Baojian/pqjc/69185.html">望诊</a></p> <p><a href="">没有文章</a></p> </div>  <div class=fanhui><a href="http://www.whrenai.com"><img src="http://images.whrenai.com/news_images/back.gif" width="180" height="34" border="0" /></a><a href="http://dgt.zoosnet.net/LR/Chatpre.aspx?id=DGT13232427" target="_blank"><img src="http://images.whrenai.com/news_images/zx1.gif" width="80" height="34" border="0" /></a><a href="http://wpa.qq.com/msgrd?V=1&Uin=179832679&Site=互动服务&Menu=yes" target="_blank"><img src="http://images.whrenai.com/news_images/zx2.gif" width="80" height="34" border="0" /></a> <input type="image" src="http://images.whrenai.com/news_images/zx3.gif" 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�?!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> 腹腔镜检�?/title> <meta name="keywords" content="<a href='/List.aspx?chid=21&Keyword=%e8%85%b9%e8%85%94%e9%95%9c&FieldName=tagnamestr' target='_blank'>腹腔�?/a> <a href='/List.aspx?chid=21&Keyword=%e6%a3%80%e6%9f%a5&FieldName=tagnamestr' target='_blank'>检�?/a>,腹腔镜检�?盆腔检�? /> <meta name="description" content=" 腹腔镜检查可清楚地观察到盆腔组织结构及卵巢肿瘤的外观性状，这对诊断及治疗卵巢疾病意义重大。特别是在决定对卵巢进行何种手术时，如是作肿瘤剔除、卵巢切除还是保留卵巢，对肿瘤性质的判断非常重要。但卵巢肿瘤性质的确定有时很困难，甚至病理学家也会对同一张切片有争议�? /> <link href="http://images.whrenai.com/news_images/new_css.css" rel="stylesheet" type="text/css"> <SCRIPT src="http://images.whrenai.com/by_images/showFlash.js"></SCRIPT> <script type="text/javascript" language="javascript" src="http://images.whrenai.com/js/copy.js "></script> <SCRIPT src="http://images.whrenai.com/by_images/showFlash.js"></SCRIPT> <script language="javascript" src="http://images.whrenai.com/zx.js"></script> <script 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href='/Baojian/Index.html'>保健频道</a> > <a href='/Baojian/nxbj/Index.html'>女性保�?/a> > <a href='/Baojian/tjjh/Index.html'>体检计划</a> > <a href='/Baojian/pqjc/Index.html'>盆腔检�?/a> > 内容阅读</div>  <div class=bt><h1>腹腔镜检�?/h1></div>  <div class=time>08-02-02 15:26:52　　　　　　</div>  <div class=key>关键词：<a href='/List.aspx?chid=21&Keyword=%e8%85%b9%e8%85%94%e9%95%9c&FieldName=tagnamestr' target='_blank'>腹腔�?/a> <a href='/List.aspx?chid=21&Keyword=%e6%a3%80%e6%9f%a5&FieldName=tagnamestr' target='_blank'>检�?/a></div>  <div class=daodu>腹腔镜检查可清楚地观察到盆腔组织结构及卵巢肿瘤的外观性状，这对诊断及治疗卵巢疾病意义重大。特别是在决定对卵巢进行何种手术时，如是作肿瘤剔除、卵巢切除还是保留卵巢，对肿瘤性质的判断非常重要。但卵巢肿瘤性质的确定有时很困难，甚至病理学家也会对同一张切片有争议�?/div>  <div class=geyan><label><span>健康谚语</span></label></div>  <div class=concent fang=08-02-02 15:26:52> <p>术中送冷冻切片具有病理学意义，但妇科医生或术者应该有对大体标本进行初步判断的能力。可根据卵巢肿瘤的形态、房腔、切面颜色、囊实性等形态做出估计，进而指导手术方案的初步制定�?/p> <p>1．瘤体特点根据瘤体形状，可初步判断卵巢肿瘤性质。北京协和医院郎景和教授根据多年的临床经验，对卵巢肿瘤的大体形状与肿瘤性质之间的关系进行了细致的观察和总结：①单房、壁薄、囊内液无色或草黄色清亮，多考虑为单纯囊肿、浆液性囊腺瘤。②多房、充满黏液、见于黏液性囊腺瘤；有内生或外生乳头是浆液性或黏液性囊腺瘤或囊腺癌。③部分为实性、伴出血、坏死，应警惕子宫内膜样癌、透明细胞癌。④切面色泽：红色，有出血、坏死，要考虑内胚窦瘤；黄色实性，见卵泡膜细胞瘤；白色实性，见于纤维上皮瘤、纤维瘤，卵巢纤维瘤可坚硬如石，为卵巢肿瘤实硬之最；灰红、棕黄、橡皮样要考虑无性细胞瘤。⑤双侧、肾形、实性半透明胶状是转移性癌的特点。⑥巧克力汁样内液是最富有特点的子宫内膜异位囊肿的内容物，但铁锈色、稀薄的液体可能是陈旧性出血，不一定是巧克力囊肿�?/p> <p><br /> 通过对卵巢肿瘤的大体性状进行观察，做出初步判断，可为术中处理提供参考�?/p> <p> <br /> 2．腹腔镜处理附件肿物注意事项</p> <p><br /> (1)检查盆腔和腹部有无肿瘤种植，肿物部位有无大量肠粘连，或腹膜有无赘生物�?(2)在开始切除前收集冲洗液，特别是对绝经后病人�?/p> <p>(3)尽量减少肿物内容物溢出，争取完整切除囊肿�?/p> <p>(4)如囊肿被切开，应检查内层上皮�?/p> <p>(5)如囊肿显示有功能，或不能切除时，应取囊壁做活组织检查�?/p> <p>(6)应将囊肿剥出或切除而不引流�?/p> <p>(7)诊断可疑时，取组织做冷冻切片检查�?/p> <p><br /> 3．腹腔镜在卵巢恶性肿瘤中的作用腹腔镜虽在治疗卵巢恶性肿瘤中的作用存在争议，但对其诊断价值及判定治疗效果时的作用不容争辩�?腹腔镜对卵巢恶性肿瘤的作用可概括为以下几个方面�?/p> <p><br /> (1)临床可疑卵巢癌的确诊：腹腔镜属微创诊治工具，虽不能作为诊断早期卵巢癌的普查方法，但对临床疑为卵巢癌的盆腔包块，或对某些盆腔包块性质不明需做鉴别诊断时，腹腔镜检查很有诊断价值�?/p> <p><br /> (2)有助于制订卵巢癌合理的治疗方案：通过腹腔镜检查可按病变性质及范围决定有无手术可能，对制订手术方式、手术前后处理方案及提示疾病预后等，均有很大的参考价值�?/p> <p> <br /> 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