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目的:研究首次行保守手术后交界性卵巢肿瘤(BOT)患者的生育功能和预后。方法:对自1990年1月至2000年5月,在我院住院43例符合研究条件的BOT患者,行问卷调查及回顾性病例分析,采用SAS软件包对数据进行处理。结果:43例患者中,41例患者完成问卷调查。26例为浆液性交界性卵巢肿瘤(SBOT);17例为粘液性交界性卵巢肿瘤(MBOT);平均随访时间63个月。术后无肿瘤复发29例,肿瘤复发14例(包括1例死于肿瘤复发,1例死于其它疾病)。平均复发时间为术后39.3个月。卵巢肿瘤剥除术后肿瘤复发率58.3%(7/12),而卵巢切除术后肿瘤复发率22.6%(7/31),两者差异有显著性(Fisher精确概率P=0.0351);但保守手术后肿瘤复发死亡率并不高于根治性手术(P=0.64)。术后24例有生育愿望的妇女,12例获得妊娠。结论:保守手术可作为BOT患者的一种治疗选择;尽管术后肿瘤复发率较高(33%,14/43),尤其是行卵巢肿瘤剥除术的患者,但肿瘤复发死亡率并未增加;术后有妊娠愿望者能够再次妊娠并分娩正常后代。
Objective: To investigate the fertility and prognosis of patients with borderline ovarian tumor (BOT) who underwent conservative surgery for the first time. Methods: From January 1990 to May 2000, 43 hospitalized patients with BOT in our hospital were investigated by questionnaire and retrospective case analysis. SAS software package was used to process the data. RESULTS: Of the 43 patients, 41 completed the questionnaire. 26 cases were serous borderline ovarian tumors (SBOT); 17 cases were mucinous borderline ovarian tumors (MBOT); the average follow-up time was 63 months. No tumor recurrence in 29 cases, 14 cases of tumor recurrence (including 1 died of tumor recurrence, 1 died of other diseases). The average recurrence time was 39.3 months after surgery. The tumor recurrence rate was 58.3% (7/12) after ovariectomy, and the recurrence rate after ovariectomy was 22.6% (7/31) (Fisher exact probability P = 0.0351). However, the conservative Postoperative tumor recurrence mortality is not higher than radical surgery (P = 0.64). Twenty-four women had postpartum aspirations and 12 had pregnancy. CONCLUSIONS: Conservative surgery may be a treatment option for patients with BOT. Although the postoperative tumor recurrence rate is high (33%, 14/43), especially in patients undergoing ovariectomized neoplasia, the tumor recurrence mortality did not increase ; Those who have the desire for pregnancy after pregnancy can give birth again and give birth to normal offspring.