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后化療的應用效果。 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：對照組行單純保留生育功能手術治療，試驗組行保留生育功能手術和術后化療，觀察兩組患者的治療有效率、隨訪12個月的腫瘤復發(fā)率和遠處轉(zhuǎn)移率、隨訪3年的自然妊娠率、成功分娩率，并對比兩組停經(jīng)患者的性激素（E2、LH、FSH）水平。 結(jié)果 試驗組的治療有效率為92.5%，高于對照組的75.0%（P<0.05）;試驗組隨訪12個月的腫瘤復發(fā)率和遠處轉(zhuǎn)移率均低于對照組（P<0.05）;試驗組的停經(jīng)率和月經(jīng)減少率均高于對照組（P<0.05）;且兩組的停經(jīng)患者中，試驗組停經(jīng)持續(xù)時間長于對照組（P<0.001）;兩組停經(jīng)患者停經(jīng)期間和月經(jīng)恢復后的E2、LH、FSH水平比較差異無統(tǒng)計學意義（P>0.05）;在月經(jīng)恢復后，兩組患者的E2、LH、FSH水平也逐漸恢復到正常范圍。隨訪觀察3年，兩組的自然妊娠率和成功分娩率比較，差異均無統(tǒng)計學意義（P>0.05）。 結(jié)論 卵巢惡性腫瘤患者行保留生育功能手術后化療會對卵巢功能造成一定不良影響，但是更有利于促進腫瘤控制，預防腫瘤復發(fā)和遠處轉(zhuǎn)移，且不會對患者的生育功能造成明顯影響。

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

[中圖分類號] R737.31? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 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.