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目的探讨年轻早期宫颈癌患者行宫颈癌根治术时加卵巢移位术的安全性及可行性。方法对2005年2月～2006年10月,我院收治的48例年龄为21～38岁,卵巢功能正常的宫颈癌Ⅰb—Ⅱa期的患者,根据病人的自愿分为,研究组20例行宫颈癌根治术时加卵巢移位;实验组15例行宫颈癌根治术时保留卵巢,不移位;对照组13例行宫颈癌根治术时切除双侧卵巢。分别于术前、术后1月、3月、6月测定三组性激素水平,观察临床表现,并进行对照分析。结果研究组和实验组术前与术后血清FSH、LH、E2值比较差异无显著性(P>0.05);阴道细胞学检查有雌激素影响。临床表现无潮热、心烦、多汗、皮肤粗糙等内分泌失调症状,性生活满意。对照组术后FSH,LH值显著增高,E2值显著降低,术前与术后血清FSH、LH、E2值比较差异有显著性意义(P<0.01)。阴道细胞学检查无雌激素影响。临床表现有潮热、多汗、烦躁、性欲减退、阴道干涩、皮肤粗糙等内分泌失调的症状。但对术后补充放射治疗后的患者,卵巢移位者4例卵巢功能正常,而未移位者2例症状同切除卵巢者。结论卵巢移位是一种安全有效的术后保留卵巢功能的方法,可以提高病人的生活质量,改善预后。
Objective To investigate the safety and feasibility of early stage cervical cancer patients undergoing radical surgery for cervical cancer with ovarian transposition. Methods From February 2005 to October 2006, 48 cases of cervical cancer Ⅰb-Ⅱa with the age of 21-38 years and normal ovarian function admitted to our hospital were divided into two groups according to their willingness: 20 in the study group Cervical cancer radical surgery and ovarian transposition; experimental group of 15 cases of cervical cancer radical surgery to retain the ovary, not shift; control group of 13 cases of cervical cancer radical excision of both ovaries. Three groups of sex hormones were measured preoperatively, 1 month, 3 months and 6 months after operation respectively. The clinical manifestations were observed and compared. Results There was no significant difference in serum FSH, LH and E2 between study group and experimental group (P> 0.05). There was estrogen in vaginal cytology examination. No clinical hot hot, upset, sweating, rough skin and other symptoms of endocrine disorders, sexual satisfaction. The FSH and LH values in the control group were significantly higher than those in the control group (P <0.01). The E2 value was significantly lower than that in the control group. There was significant difference between the preoperative and postoperative serum levels of FSH, LH and E2 (P <0.01). Vaginal cytology without estrogen effects. Clinical manifestations of hot flashes, sweating, irritability, loss of libido, vaginal dryness, rough skin and other symptoms of endocrine disorders. However, postoperative radiotherapy in patients with ovarian transposition in 4 cases of ovarian function is normal, but not two cases of transposition with the removal of ovarian symptoms. Conclusion Ovarian transposition is a safe and effective method of preserving ovarian function after operation, which can improve the quality of life of patients and improve the prognosis.