全子宫加双附件切除术对I期子宫内膜癌患者生存状况分析

Survival analysis of patients with stage I endometrial carcinoma treated by total hysterectomy and double accessory resection

摘要:

目的  探讨分析全子宫加双附件切除术对I期子宫内膜癌患者生存状况的影响。方法  分析82例I期子宫内膜癌经全子宫加双附件切除术后生活质量以及生存情况，采用多因素分析患者预后影响因素。结果  术后6个月汉密尔顿焦虑量表（HAMA）评分、汉密顿抑郁量表（HAMD）评分及焦虑自评量表（SAS）评分均高于术后3个月（P <0.05），而癌症患者生命质量测定量表（FACT-G）评分低于术前后3个月（P <0.05）。术后6个月患者女性性功能量表（FSFI）总评分及性欲望、性呼唤及性高潮等单项评分均低于术前（P <0.05）。Cox风险比例模型分析显示，年龄、病理分级、有复发高危因素及病理分期为Ⅰ期子宫内膜癌的预后不良的危险因素，术后心理干预为Ⅰ期子宫内膜癌的预后不良的保护因素。结论  Ⅰ期子宫内膜癌患者5年生存率较高，术后短期时间内患者负性情绪以及生活质量得到明显改善，但性生活质量明显下降，心理干预有助于提高患者生存质量。

Abstract:

Objective To investigate the survival status and prognostic factors of stage I endometrial carcinoma in patients underwent total hysterectomy and double appendectomy. Methods The quality of life and survival in 104 patients with stage I endometrial carcinoma after total hysterectomy and double appendectomy were analyzed. The influencing factors of prognosis were analyzed by multivariate analysis. Results The scores of HAMA, HAMD and SAS were significantly higher than those of three months after operation (P < 0.05). The scores of FACT-G were significantly lower than those of three months after operation (P < 0.05). The total score of FSFI and the scores of sexual desire, sexual call and orgasm were significantly lower than those before operation (P < 0.05). Cox proportional hazards model analysis showed that age, pathological grade, risk factors for recurrence and pathologic stage were risk factors for poor prognosis of stage I endometrial carcinoma. Postoperative adjuvant therapy and postoperative psychological intervention were poor prognosis factors in patients. Conclusions The 5-year survival rate of patients with stage I endometrial carcinoma is higher, and the negative emotion and quality of life of the patients in the short-term postoperative period are significantly improved, but the quality of life quality is obviously decreased. The psychological intervention help to improve quality of life of patients.