年轻宫颈癌患者腹腔内卵巢移位术后卵巢功能的评价  

Evaluation of transposed ovarian function in young women with cervical cancer

作　　者：吕娟[1,2] 刘志鹏[2] 任慕兰[3] 

机构地区：[1]东南大学医学院,江苏南京210009 [2]南京市妇幼保健院妇科肿瘤科,江苏南京210004 [3]东南大学附属中大医院妇产科,江苏南京210009

出　　处：《东南大学学报（医学版）》2010年第4期434-439,共6页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨年轻宫颈癌患者行腹腔内卵巢移位术对卵巢功能的影响。方法:选取2005年1月至2009年8月,南京市妇幼保健院肿瘤科收治的26例年轻宫颈癌患者为研究组,均予行广泛性子宫切除术加盆腔淋巴结清扫术,术中同时行腹腔内卵巢移位术。同时选取年轻的早期宫颈癌患者30例为对照组,行宫颈癌根治术或全子宫切除术,术中原位保留卵巢,术后未行放疗、化疗等任何治疗。术后随访并比较2组患者卵巢功能变化及围绝经期症状。结果:(1)研究组80.8%(21/26)患者保留了卵巢功能,对照组96.7%(29/30)患者保留了卵巢功能,两者比较差异无统计学意义(χ2=2.21,P>0.05)。(2)单侧和双侧卵巢移位术、左侧和右侧卵巢移位术患者的围绝经期症状发生率比较差异均无统计学意义(均P>0.05)。(3)研究组有15例患者行术后辅助放疗,33.3%(5/15)出现了围绝经期症状,均伴血清FSH异常,4例E2异常;未行辅助放疗的患者11例,没有人出现围绝经期症状。卵巢移位术后行辅助放疗和未行辅助放疗的患者围绝经期症状发生率比较,差异有显著性意义(P<0.05)。(4)15例行辅助放疗的患者中,14例测量了移位卵巢的位置,位于脐上3cm水平以下的4例患者均出现了围绝经期症状,而位于脐上3cm水平以上的10例患者,无一例出现围绝经期症状。术后行辅助放疗患者移位卵巢位置位于脐上3cm以上者和位于脐上3cm以下者比较,差异有显著性意义(P<0.05)。(5)研究组和对照组保留卵巢的并发症及患者生存率比较,差异均无统计学意义(P>0.05)。结论:腹腔内卵巢移位术保留的卵巢功能与原位卵巢功能基本一致,提高了年轻患者的生活质量;广泛性子宫切除术中将卵巢移位于脐上3cm以上水平,可防止术后放疗损伤卵巢功能。Objective：To evaluate the function of transposed ovary and its affecting factors in young women with cervical cancer.Methods：26 young patients with cervical cancer were selected as research group,they were treated in Nanjing Maternity and Child Health Care Hospital during January 2005 to August 2009.All patients were performed radical surgery and their ovaries were transposed in peritoneal cavity.At the same time,30 young patients with early cervical cancer were selected as control group.They were performed radical surgery or total hysterectomy,their ovaries were put in situ and they didn＇t accepted any treatment after operation.All cases were followed-up after operation and their ovarian function and climacteric symptoms were compared.Results：80.8%（21 /26） patients maintained their ovarian function in research group,96.7%（29 /30） patients maintained their ovarian function in control group.There was not significant difference between tow groups（P 0.05）.The climacteric symptoms of patients whose ovaries were transposed unilaterally or bilaterally,left or right had no differences,respectively（P 0.05）.However,of the patients who underwent adjuvant radiotherapy post-operation,climacteric symptoms were significantly more common（33.3%） than that of the patients without adjuvant therapy（0）（P 0.05）.Of the patients who received adjuvant radiotherapy post-operation,climacteric symptoms had significant difference between the transposed ovary located 3 cm above and 3 cm below navel level（P 0.05）.The complications and survival rates of patients had no differences in two groups（P 0.05）.Conclusion：Ovarian transposition in peritoneal cavity retained ovarian function is consistent with in situ ovarian function and it improves quality of lives of young patients.In radical hysterectomy ovaries are moved more than 3 cm above navel level,which can prevent postoperative radiation damage of ovarian function.

关 键 词：宫颈癌 卵巢移位 卵巢功能 

分 类 号：R737.33[医药卫生—肿瘤] R730.5[医药卫生—临床医学]