宫颈癌卵巢侧面移位术后卵巢内分泌功能及并发症的监测

目的调查宫颈鳞癌年轻患者卵巢侧面移位术后（LOT）卵巢内分泌功能和并发症发生率。方法对中山大学附属第二医院1998年1月至2004年1月接受宫颈癌根治性手术及LOT治疗的47例早期宫颈鳞癌年轻患者进行3次相隔半年的调查，通过围绝经期综合征量表结合血中卵泡刺激素（FSH）值判断卵巢内分泌功能；超声检查移位卵巢了解LOT术后并发症。结果3次调查中，保留正常卵巢内分泌功能的比率在术后没有辅助盆腔外放疗组分别为90．9％，88．5％，85．7％；术后加用辅助放疗组分别为81．3％，73．3％，71．4％；两组之间差异没有显著性意义（P〉0．05）；在手术年龄低于40岁的患者中为96．4％，93．5％，93．3％；手术年龄40-45岁的患者中为60．0％，50．0％，41．7％；两组之间差异有显著性意义（P〈0．05）。卵巢移位术后主要并发症为症状性卵巢囊肿，其发生率分别为5．3％，4．9％，4．8％。结论LOT能够保护卵巢不受盆腔外放疗的损伤；手术年龄与移位卵巢内分泌功能的保留有相关性；LOT术后发生的并发症主要为症状性卵巢囊肿，其发生率低。

Cross-sectional study of ovarian function and post-operational sequelae of lateral ovarian transposition in cervical cancer patients

Objective To investigate ovarian function in young women with early stage cervical squamous carcinoma who underwent lateral ovarian transposition (LOT) and to observe the sequelae of the transposed ovaries and their rates. Methods Forty-seven cervical squamous cancer patients who underwent radical hysterectomy, pelvic lymphadenectomy and LOT were recruited to our study. The patients were followed-up every half a year for three times. We used the Kupperman standard (1995) to investigate the climacteric syndrome of the patients and combined with FSH to judge ovarian function. And we also used ultrasound to image the transposed ovaries to find out the sequela of LOT. Results Among the 3 times of investigation, the rates of the patients preserving normal ovarian function were 90.9%, 88.5% and 85.7% in non radiotherapy group and 81.3%, 73.3%, and 71.4% in radiotherapy group respectively. The difference between these two groups was not significant(P>0.05). The rates of the patients preserving normal ovarian function after LOT were 96.4%, 93.5% and 93.3% in the patients under 40 years old and 60.0%, 50.0% and 41.7% in the patients between 40 to 45 years old respectively. The difference between these two groups was significant (P<0.05). The main sequela of the transposed ovary was symptomatic ovarian cyst. The rates of painful ovarian cyst formation was 5.3%, 4.9%, and 4.8% respectively in 3 times of investigation every half-year. Conclusion LOT can protect the ovary from adjuvant pelvic radiotherapy. The age when the patients accepted LOT is associated with the transposed ovarian function. The main sequela of the transposed ovary is symptomatic ovarian cyst while its' incidence is low and acceptable.