早期卵巢惡性腫瘤患者保留生育功能術(shù)后5年療效分析

里翠霜 皮紅 黃進(jìn) 白芳 祝敏捷

【摘要】目的：總結(jié)早期卵巢惡性腫瘤患者保留生育功能術(shù)后5年內(nèi)生存率、再妊娠情況及卵巢激素變化，以提高臨床認(rèn)識(shí)。方法：收集32例經(jīng)病理證實(shí)并有完整臨床隨訪資料的早期卵巢惡性腫瘤患者，所有患者均行保留生育功能術(shù)，分別于術(shù)后6個(gè)月、12個(gè)月、24個(gè)月、36個(gè)月、48個(gè)月、60個(gè)月記錄并對(duì)比患者生存率、再妊娠情況及性激素六項(xiàng)水平。結(jié)果：32例患者術(shù)后6個(gè)月、12個(gè)月、24個(gè)月、36個(gè)月、48個(gè)月、60個(gè)月生存率分別為100%、93.8%、93.8%、90.6%、87.5%、87.5%；32例患者共妊娠42次，所有患者子女5年隨訪期間健康無畸形；32例患者均行術(shù)后輔助化療，18例患者輔助化療期間停經(jīng)或月經(jīng)減少，停止化療半年后，所有患者月經(jīng)恢復(fù)正常；32例患者月經(jīng)恢復(fù)后性激素六項(xiàng)均位于正常范圍內(nèi)；患者化療前與化療后性激素六項(xiàng)水平無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：保留生育功能術(shù)對(duì)于早期卵巢惡性腫瘤患者是相對(duì)安全、可行的，值得臨床進(jìn)一步研究。

【關(guān)鍵詞】早期卵巢惡性腫瘤；保留生育功能術(shù)；療效

The 5-year clinical observation of fertility-preserving treatment for early-stage malignant ovarian tumorsLI Cuishuang1， PI Hong1， HUANG Jin1， BAI Fang1， ZHU Minjie2△. 1. Department of Obstetrics and Gynecology， Chongqing Chonggang General Hospital， Chongqing 400081， China； 2. Department of Obstetrics and Gynecology， Minhang Branch of Wujing Hospital， Yueyang Traditional Chinese Medicine and Western Medicine Combined Hospital Affiliated to Shanghai Traditional Chinese Medicine University， Shanghai 200241， China

【Abstract】Objectives： To explore the clinical effect of fertility-preserving treatment in malignant ovarian tumors and to increase the level of diagnosis and treatment. Methods： 32 patients with early-stage malignant ovarian neoplasm confirmed by pathology were analyzed， all having received fertility-preserving treatment. After a follow-up of 5 years， the survival rate， re-pregnancy and six steroid sex hormones were recorded at 6， 12， 24， 36， 48 and 60 months postoperatively. Results： The survival rate were 100%， 93.8%， 93.8%， 90.6%， 87.5% and 87.5% at 6， 12， 24， 36， 48 and 60 months postoperatively. There were 42 pregnancies in those patients. All children were healthy and free from defects in the follow-up period. All patients received adjuvant chemotherapy， and 18 cases with adjuvant chemotherapy during menopause returned to normal menstruation half a year after chemotherapy. There was no significant difference between before and after chemotherapy in six steroid sex hormones （P>0.05）. Conclusions： The fertility-preserving treatment in early-stage malignant ovarian tumors is relatively safe and feasible， deserving further clinical research.

【Key words】Early ovarian malignant tumor； Preserving fertility function； Curative effect

【中圖分類號(hào)】R737.31【文獻(xiàn)標(biāo)志碼】A

卵巢惡性腫瘤是女性常見的三大惡性腫瘤。近年來，卵巢惡性腫瘤呈年輕化趨勢(shì)，且發(fā)病率不斷升高[1]。隨著健康體檢的普及及醫(yī)學(xué)影像技術(shù)的進(jìn)步，卵巢惡性腫瘤早期發(fā)現(xiàn)、早期治療已經(jīng)成為了臨床關(guān)注熱點(diǎn)，尤其是在保留婦女生育及內(nèi)分泌功能的前提下，盡可能提高患者生存質(zhì)量是臨床的難點(diǎn)及重點(diǎn)[1，2]。保留生育功能術(shù)由于臨床實(shí)踐時(shí)間相對(duì)較短，其臨床療效是有一定爭(zhēng)議的。因此……