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目的 :探讨早期子宫颈癌患者几种不同保留卵巢手术方式的效果及术后放疗对保留卵巢的影响。方法 :2 6例 41岁以前的宫颈癌患者行根治性手术的同时 ,2例行卵巢移植术 ,2 4例行卵巢移位术 ,利用 B超及测定血清性激素水平等方法定期监测保留卵巢的功能。结果 :接受卵巢移植术者 ,术后 6个月卵巢开始周期性增大 ,术后 9～15个月恢复正常。 1例随访 12年 ,卵巢功能正常。 1例随访 10年 ,术后 9年血清性激素值接近绝经期水平。卵巢移位者 ,未接受放射治疗的 9例患者术后卵巢功能正常 ,卵巢功能持续 5～ 8年 ,平均 6 .2年。 15例术后 1个月辅助放射治疗 ,放疗结束 6个月后 ,大部分卵巢开始恢复排卵周期。辅助放疗组 ,93.3% (14/15 )的患者保持卵巢功能 ,卵巢功能持续 4～ 6年 ,平均 4.5年。辅助放疗组与未放疗组间卵巢功能持续时间差异有显著性 (P<0 .0 5 )。放射治疗组与未接受放疗组 5年生存率分别为 90 .6 %和 10 0 % (P>0 .0 5 )。结论 :卵巢移位术是一种保留年轻宫颈癌患者卵巢功能的简便有效方法 ,放射治疗对移位的卵巢功能有不良影响。
Objective: To investigate the effect of several different methods of preserving ovarian surgery and the effect of postoperative radiotherapy on preserving ovary in patients with early stage cervical cancer. Methods: Twenty-six patients with cervical cancer before the age of 41 underwent radical surgery, 2 patients undergoing ovarian transplantation and 24 patients undergoing ovarian transposition. B-ultrasonography and serum sex hormone levels were used to monitor ovarian Features. Results: Ovarian transplant recipients, ovarian 6 months after surgery began to periodically increase 9 to 15 months after the return to normal. One case was followed up for 12 years and ovarian function was normal. One case was followed up for 10 years and the serum sex hormone value was close to the menopause level at 9 years after operation. Ovariectomized, 9 patients who did not receive radiation therapy had normal ovarian function after ovarian function lasts for 5-8 years with an average of 6.2 years. 15 cases of adjuvant radiotherapy 1 month after surgery, 6 months after the end of radiotherapy, most ovaries began to restore ovulation cycle. Adjuvant radiotherapy group, 93.3% (14/15) of patients with ovarian function, ovarian function lasts 4 to 6 years, an average of 4.5 years. There was a significant difference in the duration of ovarian function between adjuvant radiotherapy group and non-radiotherapy group (P <0.05). The 5-year survival rates of radiotherapy group and non-radiotherapy group were 90.6% and 100% respectively (P> 0.05). CONCLUSIONS: Ovarian transposition is a simple and effective method to preserve ovarian function in young patients with cervical cancer. Radiation therapy has adverse effects on the transposition of ovarian function.