目的 探讨氟康唑治疗复发性外阴阴道假丝酵母菌病的临床效果。方法 选取2013年2月—2013年7月我院接受治疗的复发性外阴阴道假丝酵母菌病患者50例,患者采用口服氟康唑片治疗方式,服用三天,每天一次,每次150 mg,之后每周一次,持续服用6个月,同时配合制霉菌素以及冰硼散阴道上药,观察患者的治疗效果。结果 经过一周的治疗后,患者的临床症状和体征消失,通过镜检发现假丝酵母菌呈阴性。有49例患者在1个月和3个月的复查中没有复发情况,1例出现轻微的外阴不适并复发,1例患者在经过6个月治疗后复发,其假丝酵母菌实验室检查呈阳性。50例患者3个月的复发率为2%,6个月复发率为2%,有3例患者出现轻微的腹胀和恶心等情况。结论 采用氟康唑坚持半年的药物治疗能够提高外阴阴道假丝酵母菌疾病的治愈率并降低复发率,值得广泛推广应用。
目的 调查I-IIa期宫颈鳞状细胞癌患者术后随诊和复发情况,并探索随诊和复发的相关因素。方法 分析2011年1月—2012年6月中山市妇幼保健院收治的128例宫颈鳞状细胞癌患者的临床资料,分析他们的术后随诊情况及其影响因素。将有液基薄层细胞学(TCT)及盆腔检查者视为有效随诊的患者,分析肿瘤复发情况及其影响因素。结果 128例患者中,有效随诊104例(占总人数的81.25%)。年龄组越小,随诊率越高(P=0.034);城市患者较农村患者,随诊率高(P=0.028);文化程度越高,随诊率越高(P=0.028);职业为公务员、教师、公司职员或自由职业、个体,随诊率比职业为家庭妇女和工人更高(P=0.030)。在104例随诊者中,2年复发8例(占7.7%)。临床分期较晚,肿瘤直径>4cm,病理类型,脉管内瘤栓阳性,淋巴结转移阳性是影响患者2年复发的危险因素(P<0.05)。结论 临床分期,肿瘤直径,脉管内瘤栓阳性,淋巴结转移等临床病理特征与患者复发密切相关。应针对宫颈癌患者社会人口学特点制定措施,提高随诊率。
Objective To investigate the follow-up rate after surgical treatment and the recurrence rate among patients with cervical squamous cell carcinoma in I-IIa stage, and identify associated factors. Methods The clinical data of 128 cases of cervical squamous cell carcinoma from January 2011 to June 2012 in Zhongshan maternal and child health hospital was collected. Follow up record of these cases was analyzed and factors associated with follow up were identified. Patients having taken thinprep liquid-based cytology test (TCT) and pelvioscopy were treated as cases being followed effectively, and their recurrence and associated factors were analyzed. Results Among the 128 patients, 104(81.25%) were effectively followed. Patients with younger age(P=0.034), living in city (P=0.028), with higher education level(P=0.028) had higher follow-up rate. Civil servants, teachers and freelancers had higher follow-up rate than housewives and workers (P=0.030).Eight of the 104 effectively followed cases recurred within two years after surgery, accounting for 7.7%. The associated factors of recurrence included clinical stage, tumor diameter, larger than 4cm, the depth of myometrial invasion, deeper than 2/3, vascular tumor thrombus positive, and lymph node metastasis positive (P<0.05). Conclusion Clinical stage, tumor size, vascular tumor thrombus positive, lymph node metastasis positive were associated with recurrence. Tailored strategies should be developed to improve the follow up rate based on the social and demographic characteristics of patients.
目的 探索复发性卵巢癌放射治疗临床的效果和副作用。方法 采用回顾性分析中山大学肿瘤防治中心放射治疗中心2002年1月—2014年9月收治的复发性卵巢癌采用放射治疗的临床资料和治疗结果。结果 23例患者5年生存率为48.6%,中位生存期为54,局部无瘤生存期中位数为11.9。结论 对于局限性复发性卵巢癌放射治疗有较好的疗效和较少的副作用。
Objective To explore the clinical efficacy and side effects of radiation therapy for recurrent ovarian cancer. Methods We performed a retrospective analysis of clinical data and treatment outcomes from recurrent ovarian cancer patients who received radiation therapy from January 1999 to December 2012 at radiation treatment center of Sun Yat-sen university Cancer Center. Results Among 23 patients, the five-year survival rate was 48.6%, the median survival time was 54, and the local median disease-free survival was 11.9. Conclusion Radiation therapy has better efficacy and less side effects for non-metastatic recurrent ovarian cancer.
目的 探讨非肌层浸润性膀胱癌患者初次经尿道膀胱肿瘤电切术的复发情况及危险因素。方法 以93例非肌层浸润性膀胱癌患者进行研究，2018年1月至2022年1月西藏自治区人民政府驻成都办事处医院泌尿外科医院收治采取经尿道膀胱肿瘤电切术，术后随访24个月，复发22例，未复发71例，比较复发与未复发基础情况、不同肿瘤直径、不同肿瘤分期、分级、数量、是否带蒂、灌注化疗方式等特征患者的复发情况，对具有统计学意义的因素，采取非条件Logistic多因素回归分析，明确术后复发的危险因素。结果 肿瘤分期T1期者的复发率为32.08%，高于Ta期者15.50%，肿瘤分级为高级别者的复发率为53.33%，高于低级别者17.95%，肿瘤多发者的复发率为35.71%，高于单发者的13.73%，肿瘤不带蒂者的复发率为38.71%，高于肿瘤带蒂者的16.13%，常规灌注化疗患者的复发率为29.85%，高于术后即刻+灌注化疗患者的7.69%，比较差异均有统计学意义（χ 2 分别为6.648、4.836、6.872、6.166、5.834、5.902，P分别为0.010、0.027、0.008、0.013、0.015、0.024）。肿瘤分期T1期、肿瘤分级为高级别、肿瘤多发、常规灌注化疗为非肌层浸润性膀胱癌行初次经尿道膀胱肿瘤电切术的术后复发的危险因素（P＜0.05）。结论 非肌层浸润性膀胱癌患者初次采取经尿道膀胱肿瘤电切术容易因为临床分期为T1期、肿瘤分级为高级别、肿瘤多发及常规灌注等出现复发，应采取针对性干预措施，改进灌注化疗方式，降低复发率。
Objective To investigate the relapse and risk factors of non-muscular invasive bladder cancer after primary transurethral resection．Methods A total of 93 patients with non-muscular invasive bladder cancer were selected for study．They were received by the hospital from January 2018 to January 2022 and underwent transurethral resection．After 24 months of follow-up，22 patients recurred，and 71 patients did not recur．The recurrence of patients with different tumor diameter，tumor stage，grade，numbers，pedicel or not，and infusion chemotherapy methods were compared．For the statistically significant factors，unconditional logistic regression analysis was used to determine the independent risk factors for recurrence．Results The recurrence rate in T1 stage of tumor was 32.08% higher than that in Ta stage，which was 15.50%．The recurrence rate in high stage was 53.33% higher than that in low stage，which was 17.95%．The recurrence rate in multiple tumor patients was 35.71% higher than that in single tumor patients，which was 13.73%．The no-pedicle tumor recurrence rate was 38.71% higher than that with pedicle，which was 16.13%．The recurrence rate in patients receiving conventional infusion chemotherapy was 29.85% higher than that in patients receiving immediate postoperative infusion chemotherapy，which was 7.69%．The differences were statistically significant（χ 2 =6.648、4.836、6.872、6.166、5.834、5.902，P=0.010、0.027、0.008、0.013、0.015、0.024）．The independent risk factors of recurrence after primary transurethral resection were tumor stage T1，high grade tumors，multiple tumors，routine perfusion chemotherapy as non-muscular invasive bladder cancer（P＜0.05）．Conclusions The patients with non-muscular invasive bladder cancer taking transurethral resection for the first time are prone to recurrence because of the clinical stage of T1，tumor grade of high grade，multiple tumors and routine perfusion．Targeted intervention measures should be taken to improve the perfusion chemotherapy method to reduce the recurrence rate．
