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目的探讨宫颈癌患者行卵巢移位手术对宫颈癌患者补充同步放化疗后卵巢功能保护作用。方法收集我院宫颈癌根治术同时行卵巢移位手术的119例ⅠB1~ⅡA2期宫颈癌患者的临床资料,分为A组(卵巢移位术后未补充放疗组)及B组(卵巢移位术后补充放疗组),对2组患者术后的卵泡膜刺激素(FSH)、黄体生成素(LH)及雌激素(E2)指标进行检测,对比手术前后变化,同时对患者术后使用围绝经期综合征量表进行评分,评价卵巢移位手术对患者术后内分泌影响。结果治疗结束后6个月,A组与B组的FSH分别为(12.71±5.84)m IU/ml和(49.87±23.02)m IU/ml(P=0.011),LH分别为(9.16±3.98)m IU/ml和(31.08±5.29)m IU/ml(P=0.002),E2分别为(157.19±23.34)pmol/L和(75.15±43.08)pmol/L(P=0.022)。治疗结束后6个月,A组卵巢功能正常者37例(80.4%),B组卵巢功能正常者24例(32.9%,P<0.05)。以年龄分层,年龄<40岁者与≥40岁者治疗后6个月卵巢功能正常占比分别为45.6%和11.1%(P<0.05)。结论卵巢移位手术可以有效保护卵巢功能,但盆腔放射治疗仍然会加速卵巢功能衰退,对于年龄较小患者卵巢功能保存更好。
Objective To investigate the protective effect of ovarian function in patients with cervical cancer undergoing concurrent chemoradiotherapy after ovarian transposition. Methods The clinical data of 119 patients with stageⅠB1 ~ ⅡA2 cervical cancer who underwent radical operation for cervical cancer undergoing radical operation in our hospital were collected and divided into group A (ovarian transposition without radiotherapy) and group B (ovarian transposition Postoperative radiotherapy group), the two groups of patients after surgery, the level of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estrogen (E2) were detected before and after surgery compared changes in patients with postoperative use of Wai Menopausal Syndrome scale was scored to evaluate the effect of ovarian transposition on postoperative endocrine. Results The FSH of group A and group B were (12.71 ± 5.84) m IU / ml and (49.87 ± 23.02) m IU / ml respectively (P = 0.011) and LH were (9.16 ± 3.98) (157.19 ± 23.34) pmol / L and (75.15 ± 43.08) pmol / L, respectively (P = 0.022), mIU / ml and (31.08 ± 5.29) mIU / ml respectively. Six months after the end of treatment, 37 cases (80.4%) had normal ovarian function in group A and 24 cases (32.9%, P <0.05) in group B had normal ovarian function. The percentage of normal ovarian function at 6 months after treatment in patients with age <40 years old and ≥40 years old was 45.6% and 11.1% (P <0.05), respectively. Conclusion Ovarian transposition surgery can effectively protect ovary function, but pelvic radiotherapy will still accelerate the ovarian function decline, and ovarian function preservation is better in the younger patients.