保留生育功能的宫颈冷刀锥切术对早期宫颈癌患者预后的影响

Effect of cold knife conization of cervix preserving fertility function on the prognosis of early cervical cancer patients

目的 探讨保留生育功能的宫颈冷刀锥切术对早期宫颈癌患者预后的影响。方法 依据手术方法的不同将120例早期宫颈癌患者分为对照组和观察组,每组60例,对照组患者给予阴式广泛宫颈切除术,观察组患者给予宫颈冷刀锥切术。比较两组患者的手术相关指标、血清学指标[C反应蛋白(CRP)、癌胚抗原(CEA)、甲胎蛋白(AFP)]、妊娠结局、并发症发生情况和复发情况。结果 观察组患者手术时间和宫旁切除长度均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。手术后,两组患者CEA、AFP、CRP水平均低于本组手术前,观察组患者CRP水平低于对照组,差异均有统计学意义(P﹤0.05);手术后,两组患者CEA、AFP水平比较,差异均无统计学意义(P﹥0.05)。两组患者异位妊娠率比较,差异无统计学意义(P﹥0.05)。观察组患者的1次、2次成功妊娠率均高于对照组,流产和早产率均低于对照组,差异均有统计学意义(P﹤0.05)。随访17个月,观察组患者的并发症总发生率为6.67%,低于对照组患者的20.00%(P﹤0.05),观察组患者的复发率为3.33%,低于对照组患者的15.00%,差异有统计学意义(P﹤0.05)。结论 保留生育功能的宫颈冷刀锥切术对正常组织的损伤较小,能减少早期宫颈癌患者的术中出血量,降低并发症发生率,有利于患者的术后恢复,减轻炎性浸润和复发风险,有助于改善患者的妊娠结局。

Objective To investigate the effect of cold knife conization of cervix preserving fertility function on the prognosis of early cervical cancer patients.Method A total of 120 patients with early cervical cancer were divided into control group(n=60,treated with vaginal extensive cervical resection)and observation group(n-60,treated with cold knife conization of cervix)according to different surgical methods.The operation-related indexes,serological indicators[C-reactive protein(CRP),carcinoembryonic antigen(CEA),α-fetal protein(AFP)],pregnancy outcome,complications and recurrence were compared between the two groups.Result The observation group had significantly shorter surgical time and length of parauterine resection compared to the control group,with significantly less intraoperative bleeding compared to the control group,and the differences were statistically significant(P<0.01).After surgery,the levels of CEA,AFP,and CRP in both groups were lower than those before the surgery,while the level of CRP in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).After surgery,there were no statistically significant differences in CEA and AFP levels between the two groups(P>0.05).The 1 time,2 times successful pregnancy rate of the observation group were higher than those of the control group,and the rate of miscar-riage and premature birth were lower than those of the control group,the differences were statistically significant(P<0.05).The recurrence rate of the observation group was 3.33%,lower than the 15.00%of the control group,the difference was statistically significant(P<0.05).Conclusion Cold knife conization of cervix,which preserves reproductive func-tion,has less damage to normal tissues,can reduce intraoperative bleeding in early cervical cancer patients,reduce the in-cidence of complications,and also facilitate postoperative recovery,reduce the risk of inflammatory infiltration and recur-rence,and help improve the pregnancy outcome of patients.