术后化疗对卵巢恶性肿瘤患者的卵巢功能损伤的临床分析

目的　探讨恶性卵巢肿瘤保留生育功能手术的术后化疗对卵巢功能及胎儿的影响。方法　回顾性分析日本独协医科大学 1 990年 1月～ 1 998年 1月间收治的 9例保留生育功能手术、术后化疗的恶性卵巢肿瘤患者的临床资料结果。结果　除 1例Ⅳ期卵巢无性细胞瘤死亡外 ,其余 8例均健在 ,存活时间为 2年 1 0个月～1 1年 2个月。结婚 5例中有 4例已经妊娠分娩 ,健康婴儿 6人 ,自然流产 1例 ,人工流产 1例。 9例患者中 6例月经正常 ,其中 5例基础体温呈双相 ,黄体生成激素 (LH)、卵泡刺激素 (FSH)值均正常 ,1例化疗期间月经初潮 ;3例LH ,FSH值升高出现停经 ,分别于化疗后 2、 4、 1 2个月恢复月经来朝 ,LH ,FSH值恢复正常 ,基础体温呈双相。结论　在早期恶性卵巢肿瘤特别是卵巢生殖细胞恶性肿瘤 (包括晚期 )的手术治疗中 ,保留生育功能的手术并辅以术后化疗 ,疗效肯定 ;化疗对卵巢功能的损伤是可逆的 ,对胎儿一般无致畸作用

Analysis of damage to ovarian function in patients of malignant ovarian tumors who received chemotherapy after preservative operation

Objective To investigate the damage to ovarian function in patients of malignant ovarian tumors who received chemotherapy after preservative operation Methods The clinical information of 9 patients who underwent preservative operation followed by adjuvant chemotherapy for malignant ovarian tumors was analysed retrospectively at Dokkyo University School of Medicine from Jan 1990 to Jan 1998 Results Eight of 9 patients survived until the time of the assessment, and their survival period ranged from 2 years and 10 months to 11 years and 2 months Four patients became pregnant (8 pregnancies, 1 abortion, 1 artificial termination), no abnormality was found in any of 6 infants born from 4 patients Six of 9 patients had ovulatory cycles, 1 case had menarche during chemotherapy and had regular cycle In the other 3 cases, amenorrheic periods ranged 2-12months and there after ovulatory cycles recovered Conclusions It was well curative effect that adjuvant chemotherapy after preservative operation in the early stages malignant ovarian tumors, including terminal stages of ovarian germ cell tumor The damage of adjuvant chemotherapy to ovarian function was reversible, not cause malformation effect to fetuses commonly