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目的分析子宫颈癌放疗后宫腔积液患者的临床特点。方法回顾性分析151例子宫颈癌放疗后发生宫腔积液患者的临床资料。结果151例患者的宫颈癌临床分期为ⅡB、ⅢB期;其中宫颈腺癌32例。151例中阴道分泌物增多是主要临床症状共65例,阴道血性分泌物或阴道不规则出血32例,患者自己发现下腹部肿物27例,另27例无任何临床症状。B超检查发现宫腔积液阳性率为100%。64例为放疗后单纯宫腔积液,其中8例为宫腔积脓,除17例行子宫双附件切除外,余经扩宫引流后逐渐消失;62例为肿瘤未控或复发合并宫腔积液,19例行全子宫双附件切除,余接受补充放疗或姑息性化疗;25例为放射后发肿瘤合并宫腔积液,以全宫双附件切除,术后辅助化疗为主。三组患者中64例单纯宫腔积液的预后最好,5年生存率为54.8%。35例肿瘤未控者5年生存率为0%;27例肿瘤复发后的5年生存率为28.7%;25例放射后发肿瘤者5年生存率为47.5%,其中癌肉瘤的为0%。单纯宫腔积液的预后相对较好,放射后发肿瘤的预后次之,宫颈癌未控或复发的预后最差。结论宫颈癌放疗后出现的宫腔积液常伴有肿瘤存在,预后与是否有肿瘤因素有关。
Objective To analyze the clinical features of patients with uterine fluid after uterine cervical cancer radiotherapy. Methods The clinical data of 151 patients with uterine bleeding after cervical cancer radiotherapy were retrospectively analyzed. Results 151 cases of cervical cancer clinical stage Ⅱ B, Ⅲ B period; of which 32 cases of cervical adenocarcinoma. 151 cases of vaginal discharge is the main clinical symptoms of a total of 65 cases of vaginal bleeding or vaginal irregular bleeding in 32 cases, patients found themselves in the lower abdominal tumor in 27 cases, the other 27 cases without any clinical symptoms. B-ultrasound found that the positive rate of uterine effusion was 100%. 64 cases of uterine effusion after radiotherapy, of which 8 cases of uterine empyema, with the exception of 17 cases of double uterine adhesions, I gradually disappear after dilatation of the uterus; 62 cases of tumor uncontrolled or recurrent uterine cavity Effusion, 19 cases of hysterectomy double attachment resection, I received additional radiotherapy or palliative chemotherapy; 25 cases of tumor after radiation combined with uterine effusion to the whole house double attachment resection, postoperative adjuvant chemotherapy based. Among the three groups, the prognosis of 64 cases of simple uterine effusion was the best, and the 5-year survival rate was 54.8%. The 5-year survival rate of 35 patients with uncontrolled tumor was 0%. The 5-year survival rate of 27 patients with tumor recurrence was 28.7%. The 5-year survival rate of 25 patients with radiation-induced tumor was 47.5%, of which 0% . The prognosis of simple uterine fluid is relatively good, followed by the prognosis of radiation-induced tumor, cervical cancer uncontrolled or recurrence of the worst prognosis. Conclusion The uterine effusion that appears after radiotherapy of cervical cancer is often accompanied by the presence of tumor, the prognosis is related to the presence or absence of tumor.