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目的:探讨早期宫颈癌(CIN3~Ⅰa2)患者保留生育功能的术式选择的治疗效果。方法:选取2009年1月-2014年3月富阳市妇幼保健院26例要求保留生育功能治疗的宫颈癌患者为研究对象,收集临床资料及随访结果,对数据进行统计分析。结果:26例患者中18例CIN3选择经阴道宫颈广泛切除术(radical vaginal trachelectomy,RVT)、5例Ⅰa1与3例Ⅰa2选择经阴道子宫颈广泛性切除术+腹腔镜下盆腔淋巴结切除术,手术均成功。随访4年有1例I a2期患者术后1.6年复发,复发率3.85%(1/26);妊娠结局,在25例计划妊娠患者中,有17例共21次妊娠,4例早期流产(19.05%)、2例中期流产(9.52%)、5例早产(23.81%)、10例足月分娩(47.62%),妊娠成功率为60.00%;分娩方式,在15例成功分娩患者中,顺产5例(33.33%)、剖宫产10例(66.67%),难产率66.67%。结论:针对年轻有生育要求的早期宫颈癌患者采取不同术式,既安全有效,妊娠结局良好。
Objective: To investigate the therapeutic effect of surgical selection of reproductive function in patients with early cervical cancer (CIN3 ~ Ⅰa2). Methods: From January 2009 to March 2014, 26 cases of cervical cancer patients requiring fertility treatment in Fuyang MCH hospital were enrolled in this study. The clinical data and follow-up results were collected and the data were statistically analyzed. Results: In 26 patients, 18 cases of CIN3 underwent radical vaginal trachelectomy (RVT), 5 cases of Ia1 and 3 cases of Ia2 undergoing vaginal transvaginal sphincterotomy and laparoscopic pelvic lymphadenectomy, and surgery All succeeded. The follow-up of 4 years had 1 case of Ia2 patients with recurrence of 1.6 years postoperatively, the recurrence rate was 3.85% (1/26); pregnancy outcome, out of 25 planned pregnancy patients, a total of 21 pregnancies in 17 cases and 4 cases of early abortion 19.05%), 2 cases of interim miscarriage (9.52%), 5 cases of premature delivery (23.81%), 10 cases of full-term delivery (47.62%), pregnancy success rate of 60.00%; delivery method, 15 cases of successful delivery of patients 5 cases (33.33%), cesarean section in 10 cases (66.67%), dystocia rate of 66.67%. Conclusions: Different surgical procedures for early cervical cancer patients with reproductive requirements are safe and effective, with good pregnancy outcomes.