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作 者:杜欣颖 刘亚娜 严淑萍[2] 付翰林 毛萌[1] 王倩[1] 郭瑞霞[1,3,4] DU Xin-ying;LIU Ya-na;YAN Shu-ping;FU Han-lin;MAO Meng;WANG Qian;GUO Rui-xia(Department of Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;不详)
机构地区:[1]郑州大学第一附属医院妇科,河南郑州450052 [2]郑州大学第一附属医院病理科,河南郑州450052 [3]河南省妇科恶性肿瘤防治医学重点实验室,河南郑州450052 [4]河南省妇科肿瘤生育力保护工程研究中心,河南郑州450052
出 处:《中国实用妇科与产科杂志》2025年第3期348-352,共5页Chinese Journal of Practical Gynecology and Obstetrics
基 金:河南省中青年卫生健康科技创新领军人才培养项目(YXKC2020012)。
摘 要:目的探讨子宫颈冷刀锥切术(CKC)及筋膜外子宫切除术(EH)治疗ⅠA1期不伴淋巴脉管间隙浸润(LVSI)年轻子宫颈癌患者的临床特征及预后情况。方法回顾性分析2013年1月至2023年9月就诊于郑州大学第一附属医院的153例年龄≤45岁ⅠA1期子宫颈癌患者的临床资料,根据手术方式分为CKC组(53例)和EH组(100例)。对比分析两组的临床特征、围术期指标及预后情况,随访CKC组患者的生育结局。结果对比CKC组,EH组手术时间[(89.0±33.3)min vs.(47.6±26.1)min]、术后首次肛门排气时间[(2.2±0.5)d vs.(1.3±0.5)d]、留置尿管时间[(2.0±0.6)d vs.(1.2±0.4)d]及术后住院时间[(5.3±1.7)d vs.(3.8±1.7)d]均明显更长,且术中出血量[(33.2±27.2)mL vs.(13.1±14.6)mL]明显更多(P<0.001)。EH组有6例(6.0%)出现术后并发症。两组3年无病生存率(DFS)及总生存率(OS)均为100.0%(P>0.05)。CKC组术后妊娠率为63.2%(12/19),活产率为46.2%(6/13),早产率为50.0%(3/6)。结论CKC手术损伤小,术后恢复快,预后及生育结局良好,可作为ⅠA1期不伴LVSI年轻(≤45岁)子宫颈癌患者的治疗选择。Objective To compare and analyze the clinical characteristics and prognosis of young patients with stageⅠA1 cervical cancer without lymphovascular space invasion by cold knife conization(CKC)and by extrafascial hysterectomy(EH).Methods This study retrospectively analyzed the clinical data of 153 patients(≤45 yeas old)with stageⅠA1 cervical cancer who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to September 2023.According to different surgical methods,they were divided into CKC group(53 cases)and EH group(100 cases).The clinical characteristics,perioperative indexes and prognosis of the two groups were compared and analyzed,and the fertility outcomes of the patients in the CKC group were followed up.Results Compared with the CKC group,the EH group had significantly longer operation time[(89.0±33.3)min vs.(47.6±26.1)min],first postoperative flatus time[(2.2±0.5)d vs(.1.3±0.5)d],indwelling catheter time[(2.0±0.6)d vs(.1.2±0.4)d]and postoperative hospital stay[(5.3±1.7)d vs.(3.8±1.7)d],and significantly more intraoperative blood loss[(33.2±27.2)mL vs.(13.1±14.6)mL](P<0.001).In the EH group,6 patients(6.0%)had postoperative complications.The 3-year DFS and OS of both groups were 100.0%(P>0.05).In the CKC group,the postoperative pregnancy rate was 63.2%(12/19),the live birth rate was 46.2%(6/13),and the premature birth rate was 50.0%(3/6).Conclusions CKC is a surgical procedure with small damage.Patients treated with CKC have a fast postoperative recovery and good prognosis and fertility outcomes,and CKC can be used as a clinical choice for young patients(≤45 years old)with stageⅠA1 cervical cancer without LVSI.
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