阴道扩张术预防宫颈癌放化疗后阴道狭窄的效果

Research of Effect of Vaginal Stenosis Prevention of Vaginal Dilatation on Patients with Cervical Cancer after Radiotherapy and Chemotherapy

目的:观察阴道扩张术预防局部晚期宫颈癌患者行放化疗后阴道狭窄的效果。方法:108例行同步放化疗后的局部晚期宫颈癌患者,分为阴道扩张组(n=57)和未扩张组(n=51),在治疗结束后6个月内,阴道扩张组定期到医院进行阴道扩张及冲洗,未扩张组自行冲洗阴道(1次/d),2组患者均随访5年,比较2组患者的阴道狭窄率、阴道粘连率、性生活正常率及患者1、3、5年生存率和阴道感染率。结果:阴道扩张组患者阴道狭窄、粘连的发生率明显低于未扩张组(P<0.05),性生活正常率明显高于未扩张组(P<0.05);两组患者阴道感染率及1、3、5年生存率比较,差异无统计学意义(P>0.05)。结论:阴道扩张可以明显降低局部晚期宫颈癌患者放化疗后的阴道狭窄。

Objective： To observe the effect of vaginal dilatation in the prevention of vaginal stenosis after chemoradiotherapy in patients with locally advanced cervical cancer. Method： 108 cases of local- ly advanced cervical cancer patients with concurrent radiotherapy and chemotherapy were enrolled in the study and divided into vaginal dilatation group （57 cases） and the non vaginal dilatation group （51 cases）. 6 months after treatment, Vaginal dilatation group went to the hospital on a regular basis for vaginal dilatation and douching while non vaginal dilatation group did self-irrigation of vagina （ 1 times/ d）. 2 groups of patients were followed up for 5 years. 1, 3, and 5 year survival rate, vaginal infection rate, vaginal stenosis rate, vaginal adhesion rate and the rate of normal sexual life were compared be- tween 2 groups. Result： The incidence of vaginal stenosis and adhesions in vaginal dilatation group were significantly lower than their counterparts in non vaginal dilatation group （ P 〈 0.05 ）. The normal sexual life rate in vaginal dilatation group was significantly higher than that of non vaginal dilatation group （P 〈 0.05 ）. There were no statistically significant differences in 1, 3, 5 year survival rate be- tween two groups （ P 〉 0.05 ）. Conclusion： Vaginal dilatation can obviously reduce vaginal stenosis after chemoradiotherapy in patients with locally advanced cervical cancer.