全面分期手术对卵巢卵黄囊瘤治疗的临床意义  

Clinical significance of comprehensive staging surgery in the treatment of ovarian yolk sac tumor

作　　者：徐修云 徐晓峰[1] 李荣[1] 凌静娴[1] 周怀君[1] 黄晶晶 Xu Xiuyun;Xu Xiaofeng;Li Rong;Ling Jingxian;Zhou Huajun;Huang Jingjing(Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital,Medical School of Nanjing University,Nanjing Jiangsu 210008,P.R.C.hina)

机构地区：[1]南京大学医学院附属鼓楼医院妇产科,江苏南京210008

出　　处：《中国计划生育和妇产科》2024年第8期76-80,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨女性卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)的临床特征和预后,分析其全面分期手术的临床意义。方法回顾2004年1月至2022年1月在南京大学医学院附属鼓楼医院收治的17例OYST患者临床资料,对其发病特点、手术及预后情况进行分析。将术中行淋巴结清扫的患者作为观察组,未行淋巴结清扫的患者作为对照组。分析两组术中、术后情况。结果17例患者按FIGO分期,Ⅰ期11例、Ⅱ~Ⅳ期6例。所有患者均行保留生育功能手术,5年生存率91%。术后7例有生育计划,正常妊娠完成生育并足月分娩6例(其中1例为辅助生殖)。与对照组相比,观察组出血量更多[(837.50±211.51)mL vs.(211.67±75.04)mL,P=0.003]、手术时间更长[(223.75±101.19)min vs.(80.67±29.33)min,P=0.001]、术后肠道功能恢复更慢[(60.00±9.79)h vs.(40.00±9.34)h,P=0.003]、手术至化疗间隔时间更久[(11.25±1.25)d vs.(6.90±1.22)d,P<0.001],但一年生存率无差异(92.3%vs.100%,P=0.567)。结论OYST常见于育龄期女性,保留生育功能的手术及术后及时化疗能够有效提升生存率,其中全面分期手术增加了手术创伤,对于短期预后无差异。Objective To investigate the clinical characteristics and prognosis associated with ovarian yolk sac tumor(OYST),and analyze the clinical significance of comprehensive staging surgery.Methods A retrospective review was conducted on the clinical data from 17 OYST patients treated at Nanjing Drum Tower Hospital between January 2004 and January 2022 to analyze the incidence patterns and prognosis of these patients.The patients who underwent lymph node dissection were taken as the observation group,and those who did not undergo lymph node dissection were taken as the control group.The intraoperative and postoperative conditions between the two groups were analyzed.Results According to the FIGO staging,11 out of 17 patients were stage I,and the remaining 6 were stage II~IV.All patients underwent fertility-preserving surgery,the overall 5-year survival rate is 91%.7 patients planned for fertility after the surgery,and 6 of them successfully completed pregnancies(including 1 case involving assisted reproductive technology),all resulting in full-term deliveries.Compared with the control group,the observation group had more bleeding volume[(837.50±211.51)mL vs.(211.67±75.04)mL,P=0.003],longer surgery duration[(223.75±101.19)min vs.(80.67±29.33)min,P=0.001],slower postoperative intestinal function recovery[(60.00±9.79)h vs.(40.00±9.34)h,P=0.003],and a longer interval between surgery and chemotherapy[(11.25±1.25)d vs.(6.90±1.22)d,P<0.001].There was no difference in 1-year survival rate between the two groups(92.3%vs.100%,P=0.567).Conclusion OYST predominantly affects women of reproductive age,and fertility-preserving surgery followed by timely chemotherapy significantly enhances survival rates.The implementation of a comprehensive staging surgery,results in increased surgical trauma without difference in short-term prognosis.

关 键 词：卵巢卵黄囊瘤 预后 保留生育功能 盆腔淋巴结清扫 全面分期 

分 类 号：R737.31[医药卫生—肿瘤]