保留生育功能手术治疗早期上皮性卵巢癌患者的临床疗效及术后妊娠情况的影响因素  

Clinical efficacy of fertility preservation surgery in patients with early epithelial ovarian cancer and the influencing factors of postoperative pregnancy

作　　者：杨蕾[1] 燕海亚[1] 刘妍[1] YANG Lei;YAN Haiya;LIU Yan(Department of Gynecology,Baoji Maternal and Child Health Hospital,Baoji 721000,Shaanxi,China)

机构地区：[1]宝鸡市妇幼保健院妇科,陕西宝鸡721000

出　　处：《癌症进展》2024年第4期442-445,共4页Oncology Progress

摘　　要：目的探讨保留生育功能手术治疗早期上皮性卵巢癌患者的临床疗效及术后妊娠情况的影响因素。方法根据手术方法的不同将104例早期上皮性卵巢癌患者分为对照组(n=53,卵巢癌根治术)和观察组(n=51,保留生育功能手术)。比较两组患者的围手术期指标、并发症发生情况及复发情况,记录观察组患者的月经恢复及妊娠情况。采用Logistic回归模型分析保留生育功能手术后早期上皮性卵巢癌患者妊娠情况的影响因素。结果观察组患者术中出血量明显少于对照组,手术时间明显长于对照组,住院时间明显短于对照组,差异均有统计学意义(P﹤0.01)。两组患者的并发症总发生率及1、2年复发率比较,差异均无统计学意义(P﹥0.05)。随访2年,观察组中27例患者尝试受孕,其中9例患者妊娠成功,纳入妊娠组;另外18例患者妊娠失败,纳入未妊娠组。单因素分析结果显示,妊娠组和未妊娠组患者的临床分期、化疗情况及复发情况比较,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,临床分期、化疗情况及复发情况均是保留生育功能手术后早期上皮性卵巢癌患者妊娠情况的独立影响因素(P﹤0.05)。结论保留生育功能手术治疗早期上皮性卵巢癌患者安全可行,不会增加复发率,有生育意愿者可尝试受孕。对于合并术后妊娠危险因素的患者,临床需采取相应措施以提高妊娠率。Objective To explore the clinical efficacy of fertility preservation surgery in patients with early epithelial ovarian cancer and the influencing factors of postoperative pregnancy.Method A total of 104 patients with early epithe-lial ovarian cancer were divided into control group(n=53,radical surgery for ovarian cancer)and observation group(n=51,fertility preservation surgery)according to different surgical methods.The perioperative indexes,incidence of compli-cations and recurrence of the two groups were compared,and the menstrual recovery and pregnancy status of the observa-tion group were recorded.The influencing factors of pregnancy in patients with early epithelial ovarian cancer after fertili-ty preservation surgery were analyzed by Logistic regression model.Result The intraoperative blood loss in the observa-tion group was significantly less than that in the control group,the operation time was significantly longer than that in the control group,and the hospital stay was significantly shorter than that in the control group,and the differences were statis-tically significant(P<0.01).There were no significant differences in the total incidence of complications and the 1-year,2-year recurrence rates between the two groups(P>0.05).After 2 years follow-up,27 patients in the observation group tried to conceive,of which 9 patients had successful pregnancy,and were included in the pregnancy group;another 18 pa-tients with pregnancy failure were included in the non-pregnant group.Univariate analysis showed that there were statisti-cally significant differences in clinical stage,chemotherapy and recurrence between pregnant group and non-pregnant group(P<0.05).Multivariate Logistic regression analysis showed that clinical stage,incidence of chemotherapy and recur-rence were independent influencing factors of pregnancy in early epithelial ovarian cancer patients after fertility preserva-tion surgery(P<0.05).Conclusion Fertility preservation surgery is safe and feasible in the treatment of early epithelial ovarian can

关 键 词：保留生育功能手术 早期上皮性卵巢癌 复发 妊娠 

分 类 号：R737.31[医药卫生—肿瘤]