以腹膜延长阴道提高年轻宫颈癌患者术后生活质量的临床研究

Clinical research on quality of life of young patients improved by vagina extension with peritoneum after cervical cancer surgery

目的:探讨年轻宫颈癌患者采用腹膜延长阴道的临床意义和术后放疗对性功能的影响;方法:选择2007年以来住院年龄<45岁资料完整、随访可靠的宫颈癌患者73例分为两组,研究组41例行宫颈癌根治术加一侧或双侧卵巢移位加以腹膜延长阴道术,术前、术后3、6、12个月测性激素;对照组32例行宫颈癌根治术,或加一侧或双侧卵巢移位。两组术后高危因素者均行辅助放疗。结果:研究组术后测量阴道长度较对照组长,差异有统计学意义(P<0.01);放疗后阴道较放疗前缩短,但仍较对照组长,差异有统计学意义(P<0.01);研究组术后性生活满意度优于对照组。研究组15例行放疗,放疗后测FSH、LH明显升高,与放疗前差异有统计学意义(P<0.01),提示放疗后卵巢衰竭明显;未行放疗者卵巢功能无明显变化。结论:年轻宫颈癌患者采用腹膜延长阴道明显提高术后性生活质量,但术后行放疗是影响性功能的不利因素。

Objective： To explore the clinical significance of vagina extension with peritoneum in young patients with cervical canc- er and the effect of postoperative radiotherapy on sexual function. Methods： 73 patients with cervical cancer whose hospitalized ages were less than 45 years,with intact data and reliable follow - up results were selected from 2007 so far,then they were divided into two groups,41 patients in study group were treated with hysterectomy for cervical cancer,unilateral or bilateral ovarian transplantation plus vagina extension with peritoneum,the levels of sexual hormones were detected before operation,3,6 and 12 months after operation; 32 patients in control group were treated with hysterectomy for cervical cancer,unilateral or bilateral ovarian transplantation. The patients with high risk factors in the two groups received adjuvant radiotherapy after operation. Results： The vaginal length after operation in study group was longer than that in control group （ P 0. 01） ; in study group,the vaginal length after radiotherapy was shorter than that before radiotherapy,but it was still longer than that in control group （ P 0. 01） . The satisfaction of sexual life after operation in study group was higher than that in control group. 15 patients in study group underwent radiotherapy,after radiotherapy,the levels of FSH and LH increased obviously,compared with before radiotherapy,there was significant difference （ P 0. 01） ,which indicated that ovarian function after radiotherapy decreased obviously; the ovarian function of patients without radiotherapy didn＇t change significantly. Conclusion： Vagina extension with peritoneum can improve the quality of sexual life for young patients with cervical cancer,but postoperative radiotherapy is an adverse factor affecting sexual life.