本文選題：卵巢上皮性癌　切入點(diǎn)：化療　出處：《青島大學(xué)》2017年碩士論文

【摘要】：目的:回顧性分析我院142例卵巢癌患者化療前后血糖變化的臨床特征,探討卵巢癌化療后影響血糖變化的因素與其臨床結(jié)局的相關(guān)性。方法:對(duì)我院2008年1月至2015年8月收治的142例卵巢癌術(shù)后患者做回顧性分析,收集化療前后的血糖數(shù)據(jù),分析患者化療前后血糖變化,從中篩選出糖代謝紊亂患者,分析其臨床特征等方面的資料,對(duì)卵巢癌患者術(shù)后血糖代謝紊亂的發(fā)病率、病因以及相關(guān)危險(xiǎn)因素進(jìn)行系統(tǒng)的分析,進(jìn)而研究化療后血糖變化的規(guī)律以及影響因素與臨床結(jié)局的關(guān)系。結(jié)果:(1)142例患者均在我院行手術(shù)治療且達(dá)到滿意腫瘤細(xì)胞減滅術(shù),均經(jīng)病理確診為卵巢上皮性癌,年齡為34.5~72歲,中位年齡52.5歲。年齡段主要集中在46~65為主,共97例(97/142)約占68.31%,其中46~55歲,共46例,約占32.39%,56~65歲共51例,約占35.92%。142例患者平均隨診32.5個(gè)月(16個(gè)月~50個(gè)月)。(2)142例患者化療前空腹血糖正常,化療后(6個(gè)療程)空腹血糖異常升高37例,占總例數(shù)26.06%(37/142),其中空腹血糖調(diào)節(jié)受損患者28例,占總例數(shù)19.72%(28/142),確診糖尿病患者9例,占總例數(shù)6.34%(9/142)。出現(xiàn)空腹血糖升高的患者CTCAE分級(jí)主要集中在1級(jí)至3級(jí),其中1級(jí)30例,構(gòu)成比約81.08%。(3)對(duì)血糖正常組與異常組的高血壓病史情況進(jìn)行x2檢驗(yàn),p0.05,差異有統(tǒng)計(jì)學(xué)意義。(4)BMI23者有42例(29.58%),化療時(shí)血糖升高者有8例,比例為19.05%。而BMI≥23者有100例(70.42%),化療時(shí)血糖升高者有29例,比例為29.00%。血糖升高組與正常組的BMI其差異存在統(tǒng)計(jì)學(xué)意義(p0.05)。(5)未絕經(jīng)患者有43例,占比為30.28%�；熎陂g血糖升高者有8例,比例為18.60%。絕經(jīng)患者有96例,占比為67.61%�；煏r(shí)血糖升高者有29例,比例為29.29%。統(tǒng)計(jì)結(jié)果表明差異有顯著性意義。(6)142例卵巢癌患者中,平均隨診32.5個(gè)月(16個(gè)月~50個(gè)月),在隨診期間出現(xiàn)腫瘤復(fù)發(fā)者共45例,占比為31.69%。其中血糖升高者有27例,占血糖異常組的60%,血糖正常組復(fù)發(fā)18例,占總復(fù)發(fā)例數(shù)的40%,統(tǒng)計(jì)結(jié)果表明血糖升高者術(shù)后復(fù)發(fā)率明顯高于血糖正常者。結(jié)論:高齡、高血壓、高BMI、已絕經(jīng)的卵巢癌患者化療后容易出現(xiàn)空腹血糖異常,且多發(fā)生在化療后第四個(gè)周期,控制血糖能改善臨床結(jié)局。
[Abstract]:Objective: to retrospectively analyze the clinical characteristics of blood glucose changes in 142 patients with ovarian cancer before and after chemotherapy. Methods: 142 patients with ovarian cancer treated from January 2008 to August 2015 were retrospectively analyzed and their blood glucose data were collected before and after chemotherapy. To analyze the changes of blood glucose before and after chemotherapy, to screen out the patients with glucose metabolism disorder, to analyze its clinical characteristics, and to analyze systematically the incidence, etiology and related risk factors of blood glucose metabolism disorder after operation in patients with ovarian cancer. The changes of blood glucose after chemotherapy and the relationship between the influencing factors and the clinical outcome were studied. Results all of the 142 patients underwent surgical treatment in our hospital and achieved satisfactory tumor cell reduction. All of them were pathologically diagnosed as ovarian epithelial carcinoma, aged 34.5 or 72 years. The median age was 52.5 years old. The main age group was 460.65 (97 / 97 / 142) accounting for 68.31, 46 of which were 4655 years old, accounting for 51.51 cases were about 32.390.5665 years old, about 35.922.142 patients were followed up for an average of 32.5 months (16 months ~ 50 months), 2142 patients had normal fasting blood glucose before chemotherapy. After 6 courses of chemotherapy, 37 cases of abnormal increase of fasting blood glucose were found, accounting for 26.06% and 37% of 142 cases. Among them, 28 cases were impaired in fasting blood glucose regulation, accounting for 19.72% of the total number of cases, and 9 cases were diagnosed with diabetes mellitus. The CTCAE grade of patients with increased fasting blood glucose was mainly in grades 1 to 3, of which 30 were grade 1. The constitution ratio was about 81.088.The history of hypertension in normal group and abnormal group was tested by x2 test (p0.05). The difference was statistically significant. There were 42 cases with BMI23 and 8 cases with elevated blood sugar during chemotherapy. The ratio was 19.05.There were 43 cases (30.28%) of unmenopausal patients with BMI 鈮，

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