嵇海舟　任密

[摘要] 目的 探討卵巢惡性腫瘤患者行保留生育功能手術(shù)后化療的應(yīng)用效果。 方法 回顧性收集我院婦科2015年2月至2016年10月收治的卵巢惡性腫瘤患者80例的臨床資料，根據(jù)治療方法分組：對(duì)照組行單純保留生育功能手術(shù)治療，試驗(yàn)組行保留生育功能手術(shù)和術(shù)后化療，觀察兩組患者的治療有效率、隨訪12個(gè)月的腫瘤復(fù)發(fā)率和遠(yuǎn)處轉(zhuǎn)移率、隨訪3年的自然妊娠率、成功分娩率，并對(duì)比兩組停經(jīng)患者的性激素（E2、LH、FSH）水平。 結(jié)果 試驗(yàn)組的治療有效率為92.5%，高于對(duì)照組的75.0%（P<0.05）;試驗(yàn)組隨訪12個(gè)月的腫瘤復(fù)發(fā)率和遠(yuǎn)處轉(zhuǎn)移率均低于對(duì)照組（P<0.05）;試驗(yàn)組的停經(jīng)率和月經(jīng)減少率均高于對(duì)照組（P<0.05）;且兩組的停經(jīng)患者中，試驗(yàn)組停經(jīng)持續(xù)時(shí)間長(zhǎng)于對(duì)照組（P<0.001）;兩組停經(jīng)患者停經(jīng)期間和月經(jīng)恢復(fù)后的E2、LH、FSH水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;在月經(jīng)恢復(fù)后，兩組患者的E2、LH、FSH水平也逐漸恢復(fù)到正常范圍。隨訪觀察3年，兩組的自然妊娠率和成功分娩率比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。 結(jié)論 卵巢惡性腫瘤患者行保留生育功能手術(shù)后化療會(huì)對(duì)卵巢功能造成一定不良影響，但是更有利于促進(jìn)腫瘤控制，預(yù)防腫瘤復(fù)發(fā)和遠(yuǎn)處轉(zhuǎn)移，且不會(huì)對(duì)患者的生育功能造成明顯影響。

[關(guān)鍵詞] 卵巢惡性腫瘤;保留生育功能手術(shù);化療;性激素;停經(jīng);妊娠率

[中圖分類號(hào)] R737.31? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2021）20-0093-04

Analysis of application effect and effective rate of chemotherapy after fertility preserving surgery for patients with ovarian malignant tumor

JI Haizhou? ?REN Mi

Tenth Area of Department of Gynaecology，F(xiàn)ujian Provincial Cancer Hospital，F(xiàn)uzhou? ?350014，China

[Abstract] Objective To explore the application effect of chemotherapy after fertility preserving surgery for patients with ovarian malignant tumor. Methods The clinical data of 80 patients with ovarian malignant tumor admitted to our Department of Gynecology from February 2015 to October 2016 were retrospectively collected and grouped according to treatment methods.The control group was treated with fertility preserving surgery alone，and the experimental group was treated with fertility preserving surgery and postoperative chemotherapy.The treatment effective rates，tumor recurrence rates and distant metastasis rates after 12-month follow-up，natural pregnancy rates after 3-year follow-up，and successful delivery rates were observed in the 2 groups.The levels of sex hormones （E2，LH，F(xiàn)SH） in the two groups were compared. Results The treatment effective rate of the experimental group was 92.5%，which was higher than 75.0% of the control group （P<0.05）. The tumor recurrence rate and distant metastasis rate in the experimental group were lower than those in the control group after 12-month follow-up （P<0.05）. The rate of menopause and loss of menstruation in the experimental group were higher than those in the control group（P<0.05）. In both groups，the duration of menopause in the experimental group was longer than that in the control group （P<0.001）. No significant differences were observed in E2，LH and FSH levels between the two groups during menopause and after menstrual recovery（P>0.05）. After menstruation resumed，the levels of E2，LH and FSH in both groups gradually returned to the normal range. After 3-year follow-up，no significant differences were observed in the natural pregnancy rates and successful delivery rates between the two groups（P>0.05）. Conclusion In patients with ovarian malignant tumor，chemotherapy after fertility preserving surgery will cause certain adverse effects on the ovarian function，but it is more conducive to promoting tumor control，and preventing tumor recurrence and distant metastasis，and will not cause significant effects on the fertility of the patients.