宫颈癌患者卵巢移位手术后放射治疗对卵巢功能的作用分析

目的探讨卵巢移位术对宫颈癌患者放射治疗后卵巢功能的作用。方法选取2008年5月至2012年5月收治的40例宫颈癌患者为研究对象，行卵巢移位术治疗，并按照患者放射治疗指征在手术后进行放射性治疗，观察其手术前、手术后和放射治疗结束1个月后和放射治疗结束6个月后血清中性激素水平以及随访情况。结果手术后患者血清性激素水平无明显变化，化疗结束1个月后垂体分泌卵泡刺激素（FSH）和促黄体生成素（LH）水平明显上升，雌二醇（E2）和孕酮（P）水平明显下降（P〈0．05），并于化疗结束6个月后恢复手术前水平。放射治疗结束6个月后，25例患者出现潮热、盗汗、烦躁、失眠等围绝经期症状，性生活满意度为37．5％，且复发1例，手术后生活质量（QOL）满意度为51．2％，无死亡病例。放射治疗结束1年后围绝经期症状自行消失，仅3例患者存在围绝经期症状，性生活满意度为95．0％，QOL满意度96．4％，2例复发，患者全部生存。放射治疗结束6个月与1年后两组在围绝经期症状、性生活满意度和QOL满意度差异均具有统计学意义（P〈0．05）。结论卵巢移位术能够有效保护宫颈癌患者放射治疗后卵巢功能，操作方便、疗效可靠，且明显降低了复发率，对患者手术后生活质量的提高具有重要意义，值得临床广泛推广。

Effects of ovarian transposition on ovarian function of patients with cervical cancer after radiotherapy

Objective To explore the effect of ovarian transposition on ovarian function of patients with cervical cancer after radiotherapy. Methods From May 2008 to May 2012 in our hospital,40 cases of cervical cancer patients were supposed to experience ovarian transposition and radiotherapy. Meanwhile, the serum sex hormone levels of pre-, pest- as well as follow-ups were recorded according to the indications in radioactive treatment. Results There was no significant changes of serum sex hormones levels in patients with postoperative chemotherapy, the levels of FSH and LH index were significantly increased, whist E2 and P significantly decreased （ P 〈 0.05 ）, the levels above mentioned recover to baseline （preoperative） after 6-months chemotherapy, 25 patients have symptoms of hot flashes, sweating, irritability, insomnia and other surrounding menopausal symptoms. Life satisfaction was 37. 5% with 1 case recurrence and no death. QOL satisfaction was 51.2%. After 1 year radiotherapy, perimenopausal symptoms disappeared, menopausal symptoms observed in only 3 patients, life satisfaction was 95.0%, with 2 cases recurrence. QOL satisfaction was 96.4%. There were statistical differences between the end of radiotherapy for 6 months and 1 year after menopause symptoms as well as life and QOL （ P 〈 0. 05 ）. Conclusions Ovarian transposition can effectively protect the ovarian function of cervical cancer patients after radiotherapy, with convenient operation, reliable effect, and significantly reduces the recurrence rate of postoperative patients, significantly improving quality of life. It was worthy of further clinical promotion.