妇科恶性肿瘤术后骨质疏松症的临床观察

Clinical observation of osteoporosis in gynecological malignancies patients underwent surgery

目的观察妇科恶性肿瘤术后骨密度（bone mineral density,BMD）的变化情况,为术后骨质疏松症的防治提供理论基础。方法以2013年10月-2015年11月我院收治的26例妇科恶性肿瘤患者为试验组,其中宫颈癌患者14例,子宫内膜癌患者4例,卵巢癌患者8例,年龄38-53岁,平均年龄（46.01±4.13）岁,患者术中均行子宫全切术和双侧附件切除术;以同期在我院进行体检的同年龄段30例健康女性作为对照组,采用双能X线骨密度仪测定受试者腰正位（L3-4）及左髋部（股骨颈）的BMD情况;同时测定其血清激素水平情况。结果与对照组相比,妇科恶性肿瘤术后腰椎BMD明显下降（P〈0.05）,有统计学意义;血清雌二醇（estradiol,E2）值与对照组比较有所下降（P〈0.05）,促卵泡刺激素（follicle-stimulating hormone,FSH）与对照组比较有明显上升（P〈0.05）,均有统计学意义。结论妇科恶性肿瘤术后因雌激素急剧下降可加速骨质丢失,术后尽早防治骨质疏松对提高患者生活质量有很大的作用。

Objective To study the changes in bone mineral density（ BMD） in patients underwent hysterectomy and bilateral oophorectomy due to gynecological malignancies,and to provide a theoretical basis for the prevention and treatment of osteoporosis in these patients. Methods The experimental group included 26 cases of gynecological cancer patients aged 38 to 53 years who were admitted from October 2013 to November 2015,in which 14 patients had cervical cancer,4 had endometrial cancer,8 had ovarian cancer. The average age was 46. 01 ± 4. 13 years. These patients underwent hysterectomy and bilateral oophorectomy. Thirty healthy women of the same age who were in the hospital for physical examination at the same period were recruited as a controls.Using dual energy X-ray bone densitometry,anteroposterior lumber spine（ L3-L4） and left hip（ femoral neck） bone mineral density（ BMD） was assessed; and serum hormone levels were measured. Results Compared with the control group,gynecological malignancy patients underwent surgery had significantly lower lumbar spine BMD（ P〈0. 05）,and serum E2 levels（ P〈0. 05）,but significantly higher FSH levels（ P〈0. 05）. Conclusion Gynecological malignancies patients underwent surgery have a sharp decline in estrogen which can accelerate bone loss. Taking procedures to prevent and treat osteoporosis as early as possible after surgery in these patients could improve their quality of life.