李凤虎,冉立,常建英,李杰慧,洪卫,单朗,栗惠琴
LI Fenghu,RAN Li,CHANG Jianying,LI Jiehui,HONG Wei,SHAN Lang,LI Huiqin

• 1:贵州省肿瘤医院贵州医科大学附院乳腺妇科肿瘤科

摘要(Abstract)：

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 locally 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( 51cases). 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 between 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 between two groups( P > 0. 05). Conclusion: Vaginal dilatation can obviously reduce vaginal stenosis after chemoradiotherapy in patients with locally advanced cervical cancer.

关键词(KeyWords)： 宫颈肿瘤;阴道;扩张术;放射疗法;化学疗法,辅助;粘连
cervical cancer;vagina;dilatation;radiotherapy;chemotherapy;adjuvant;adhesion

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生计划生育委员会资助项目(GZWKJ2012-1-098)

作者(Author): 李凤虎,冉立,常建英,李杰慧,洪卫,单朗,栗惠琴
LI Fenghu,RAN Li,CHANG Jianying,LI Jiehui,HONG Wei,SHAN Lang,LI Huiqin

DOI: 10.19367/j.cnki.1000-2707.2016.08.018

参考文献(References)：

• [1]Pecorelli S.Revised FIGO staging for carcinoma of the vulsa,cevix,and endometrium[J].Int J Gynaecol Obstet,2009(105):103-104.
• [2]韩雪,黄辰曦,赵佳,等.2002-2012年上海市杨浦区社区人群宫颈癌的发病和生存情况分析[J].第二军医大学学报,2014(35):26-29.
• [3]潘祯,冯素文.年轻患者宫颈癌放疗预防阴道粘连及狭窄的护理[J].中国初级卫生保健,2013(11):102-103.
• [4]刘伟,孙一平,陈蕾.139例中晚期宫颈癌放疗患者行阴道冲洗的临床观察与护理[J].健康之路,2014(13):12.
• [5]李连弟,鲁凤珠,张思维,等.中国恶性肿瘤死亡率20年变化趋势和近期预测分析[J].中华肿瘤杂志,1997(19):3-9.
• [6]Li ZJ,Yang SY,Liu L,et al.A comparison of concurrent chemoradio-therapy and radiotherapy in Chinese patients with locally advanced cervical carcinoma:a multi-center study[J].Radiation Oncology,2014(9):212.
• [7]邓秋梅.碘伏在宫颈癌放疗患者阴道冲洗的疗效观察[J].右江医学,2009(37):174-175.
• [8]李翠梅.子宫内膜癌腔内放射治疗的护理及效果观察[J].基层医学论坛,2015(14):1898-1899.
• [9]吴雪容,张莹娟,成洁,等.宫颈癌患者行同步放化疗后持续阴道冲洗的效果观察[J].世界最新医学信息文摘,2014(14):62-63.
• [10]万佩玲,王新.阴道冲洗对宫颈癌患者治疗的近期及远期作用研究[J].临床合理用药,2011(4):23.
• [11]王静,许可葵,史百高,等.4 374例宫颈癌患者预后及其影响因素分析[J].中国肿瘤,2014(23):281-287.
• [12]毛世华,张涛,谈宗国,等.178例宫颈癌放疗疗效及预后相关因素分析[J].实用癌症杂志,2014(29):829-831.

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