2018早期卵巢恶性肿瘤患者保留生育功能术后5年疗效分析

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　　【摘要】目的：总结早期卵巢恶性肿瘤患者保留生育功能术后5年内生存率、再妊娠情况及卵巢激素变化，以提高临床认识。方法：收集32例经病理证实并有完整临床随访资料的早期卵巢恶性肿瘤患者，所有患者均行保留生育功能术，分别于术后6个月、12个月、24个月、36个月、48个月、60个月记录并对比患者生存率、再妊娠情况及性激素六项水平。结果：32例患者术后6个月、12个月、24个月、36个月、48个月、60个月生存率分别为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年随访期间健康无畸形；32例患者均行术后辅助化疗，18例患者辅助化疗期间停经或月经减少，停止化疗半年后，所有患者月经恢复正常；32例患者月经恢复后性激素六项均位于正常范围内；患者化疗前与化疗后性激素六项水平无统计学意义（P>0.05）。结论：保留生育功能术对于早期卵巢恶性肿瘤患者是相对安全、可行的，值得临床进一步研究。
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　　【关键词】早期卵巢恶性肿瘤；保留生育功能术；疗效
　　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
　　【中图分类号】R737.31【文献标志码】A
　　卵巢恶性肿瘤是女性常见的三大恶性肿瘤。近年来，卵巢恶性肿瘤呈年轻化趋势，且发病率不断升高[1]。随着健康体检的普及及医学影像技术的进步，卵巢恶性肿瘤早期发现、早期治疗已经成为了临床关注热点，尤其是在保留妇女生育及内分泌功能的前提下，尽可能提高患者生存质量是临床的难点及重点[1，2]。保留生育功能术由于临床实践时间相对较短，其临床疗效是有一定争议的。因此，笔者收集2007年5月至2012年12月到我院住院治疗的32例早期卵巢恶性肿瘤患者进行研究，通过术后5年随访对该32例保留生育功能术的卵巢恶性肿瘤患者的疗效进行分析，并对保留生育功能治疗的有效性、可行性及安全性进行总结。现报道如下。