保留卵巢功能的宫颈癌根治术对宫颈癌病人预后及生活质量的影响  

Effect of the radical resection of ovarian cancer with ovarian function reservation on the prognosis and quality of life of patients with cervical cancer

作　　者：王艳[1] WANG Yan(Department of Gynaecology and Obstetrics,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院妇产科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2018年第11期1424-1427,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨保留卵巢功能的宫颈癌根治术对宫颈癌病人预后的影响。方法:选取手术治疗的宫颈癌病人358例,按照手术方式分为观察组83例,行保留卵巢的宫颈癌根治术;对照组275例,行不保留卵巢的宫颈癌根治术。术后3、6个月,分别进行血清学性激素水平测定;术后6个月,采用改良Kupperman评分法进行生活质量问卷调查。结果:术后6个月,观察组病人改良Kupperman评分明显低于对照组(P <0. 01)。术后3、6个月,观察组FSH、LH、E2水平均在正常值范围,3例出现卵巢衰竭表现;对照组术后3、6个月FSH、LH均明显高于观察组(P <0. 01),E2水平明显低于观察组(P <0. 01)。观察组病人术后随访,其中2例卵巢转移,4例出现卵巢脓肿,1例有残留卵巢综合征,3例保留卵巢的病人出现移植部位疼痛。结论:宫颈癌符合保留卵巢功能的病人术中给予保留单/双侧卵巢是可行的,保留卵巢功能使宫颈癌病人获益,提高病人术后生活质量,且术中保留卵巢是安全的,极少病人出现卵巢转移。Objective： ： To investigate the effects of the radical resection of ovarian cancer with ovarian function reservation on the prognosis of patients with cervical cancer. Methods： Three hundred and fifty-eight patients with cervical cancer were divided into the observation group（ 83 cases） and control group（ 275 cases）. The observation group and control group were treated with the radical resection of ovarian cancer with and without ovarian function reservation,respectively. After 3 and 6 months of operation,the serum levels of sex hormone in two groups were detected. After 6 months of operation,and the quality of life in two groups was investigated using Kupperman score,and the TCT and imaging examinations in two groups were regularly performed after operation. Results： After 6 months of operation,the modified Kupperman score in observation group was significantly lower than that in control group（ P〈0. 01）.After 3 and 6 months of operation,the levels of FSH,LH and E2 in observation group were normal,and only 3 cases with ovarian failure were found. After 3 and 6 months of operation,the levels of FSH and LH in control group were significantly higher than those in observation group（ P〈0. 01）,and the level of E2 in control group was significantly lower than that in observation group（ P〈0. 01）.The observation group was followed up,and the ovarian metastasis in 2 cases,ovarian abscess in 4 cases,residual ovarian syndrome in 1 case and ovarian transplantation pain in 3 cases were identified. Conclusions： The reservation of single/bilateral ovary in cervical cancer patients who is eligible to retain ovarian function,is feasible. Preserving ovarian function can improve the quality of life,the intraoperative ovarian preservation is safe,and few patients appear ovarian metastasis.

关 键 词：子宫颈肿瘤 卵巢 宫颈癌根治术 改良Kupperman评分 卵巢转移 

分 类 号：R737.33[医药卫生—肿瘤]