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目的探讨宫颈癌根治术与同步放化疗后宫颈癌患者性生活质量的差异。方法选取2017年10月至2019年1月于北京协和医院妇科肿瘤门诊随诊的治疗后宫颈癌患者369例为研究对象,按照治疗方式的不同分为手术组(257例)和放化疗组(112例),并将治疗后性生活活跃患者(204例)按治疗方式分为A组(行手术治疗者,147例)和B组(行放化疗治疗者,57例)。收集患者的一般资料,采用女性性功能量表(FSFI)对宫颈癌患者的性生活质量进行评分,分析各组患者的临床特征,比较治疗后FSFI量表得分情况。结果入组的369例原发性宫颈癌患者,年龄28～59岁,中位数年龄47岁,中位数随访时间35.8月;257例接受了根治性子宫切除术,112例接受了根治性同步放化疗。369例患者FSFI量表平均得分14.4分;204例(55.3%)患者治疗后性生活活跃,FSFI总分平均值为(22.9±5.4)分;165例无性生活患者中,99例(60.0%)因为对疾病相关的担心及不适。组间比较结果显示,手术组患者整体性生活质量显著高于放化疗组,FSFI评分[(15.2±10.6)分]显著高于放化疗组[(12.7±9.8)分](P<0.05)。治疗后性生活活跃的204例患者中,A组的FSFI得分[(23.4±5.6)分]显著高于B组[(21.6±4.6)分](P<0.05)。结论对于宫颈癌患者,不同的治疗方式可能影响治疗后性生活质量,根治性放化疗对阴道功能的影响更为明显。
Abstract：Objective:To explore the quality of sexual life after treatment in cervical cancer survivors.Methods:Patients with cervical cancer who were followed up in the outpatient department of Peking Union Medical College Hospital from October 2017 to January 2019 were enrolled.Female sexual function index(FSFI)was used to score the quality of life of cervical cancer patients.Results:A total of 369 patients with cervical cancer under the age of 60 were included in the study,with a median age of 47 years and a median follow-up of 35.8 months.Of these patients,257 underwent radical hysterectomy;112 received concurrent chemoradiotherapy.The average score of the FSFI was 14.4 points,of which 55.3%(204/369)were active in sexual life and obtained(22.9±5.4)points in the FSFI.For 165 patients without normal sexual life,60.0% were caused by disease-related concerns and discomfort.The grouping results showed that the overall quality of sexual life of the patients in the surgical group was higher than that in the radiotherapy group [(15.2±10.6)vs.(12.7±9.8)points,P<0.05].And in subgroup analysis for patients with active sexual life,patients after surgery gained a higher score of FSFI than those after radiotherapy[(23.4±5.6)vs.(21.6±4.6),P<0.05]Conclusions:The treatment of cervical cancer patients affects the quality of sexual life,and radical chemoradiotherapy has a greater impact on vaginal function.
[1]Ferlay J,Soerjomataram I,Dikshit R,et al.Cancer incidence and mortality worldwide:sources,methods and major patterns in GLOBOCAN 2012[J].Int J Cancer,2015,136:E359-386.
[2]Small W Jr,Bacon MA,Bajaj A,et al.Cervical cancer:Aglobal health crisis[J].Cancer,2017,123:2404-2412.
[3]Fleming ND,Ramirez PT,Soliman PT,et al.Quality of life after radical trachelectomy for early-stage cervical cancer:A5-year prospective evaluation[J].Gynecol Oncol,2016,143:596-603.
[4]Park JY,Kim DY,Suh DS,et al.Reproductive outcomes after laparoscopic radical trachelectomy for early-stage cervical cancer[J].J Gynecol Oncol,2014,25:9-13.
[5]Song T,Choi CH,Lee YY,et al.Sexual function after surgery for early-stage cervical cancer:is there a difference in it according to the extent of surgical radicality?[J].J Sex Med,2012,9:1697-1704.
[6]Plotti F,Terranova C,Capriglione S,et al.Assessment of quality of life and urinary and sexual function after radical hysterectomy in long-term cervical cancer survivors[J].Int JGynecol Cancer,2018,28:818-823.
[7]Hofsj9A,Bergmark K,Blomgren B,et al.Radiotherapy for cervical cancer-impact on the vaginal epithelium and sexual function[J].Acta Oncol,2018,57:338-345.
[8]Rosen R,Brown C,Heiman J,et al.The Female Sexual Function Index(FSFI):a multidimensional self-report instrument for the assessment of female sexual function[J].JSex Marital Ther,2000,26:191-208.
[9]Baser RE,Li Y,Carter J.Psychometric validation of the Female Sexual Function Index(FSFI)in cancer survivors[J].Cancer,2012,118:4606-4618.
[10]Liu H,Yu J,Chen Y,et al.Sexual function in cervical cancer patients:Psychometric properties and performance of a Chinese version of the Female Sexual Function Index[J].Eur J Oncol Nurs,2016,20:24-30.
[11]Donovan KA,Taliaferro LA,Alvarez EM,et al.Sexual health in women treated for cervical cancer:characteristics and correlates[J].Gynecol Oncol,2007,104:428-434.
[12]Lee Y,Lim MC,Kim SI,et al.Comparison of quality of life and sexuality between cervical cancer survivors and healthy women[J].Cancer Res Treat,2016,48:1321-1329.
[13]Juraskova I,Butow P,Robertson R,et al.Post-treatment sexual adjustment following cervical and endometrial cancer:a qualitative insight[J].Psychooncology,2003,12:267-279.
[14]Andersen BL,Anderson B,deProsse C.Controlled prospective longitudinal study of women with cancer:I.Sexual functioning outcomes[J].J Consult Clin Psychol,1989,57:683-691.
[15]周莲清,刘华云,谌永毅,等.子宫颈癌患者性生活质量影响因素分析[J].中国护理管理,2015,15:158-161.
基本信息:
中图分类号:R737.33
引用信息:
[1]李文慧,吴鸣,谭先杰.宫颈癌根治术与放化疗对患者性生活质量的影响[J].生殖医学杂志,2019,28(07):764-767.
基金信息:
国家自然基金项目(81172483)
2019-07-15
2019-07-15