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妇科恶性肿瘤发病年轻化及诊疗水平提升使早期患者生存率显著提高，保留生育功能成为临床关注重点，推动诊疗理念从“生存优先”向“兼顾生活质量”转变。本文系统综述早期宫颈癌、子宫内膜癌、卵巢相关恶性肿瘤的生育力保存策略：明确各肿瘤生育力保留的核心适应证，阐述保留生育力手术、药物治疗的核心方案及相关临床研究证实的肿瘤学安全性与妊娠结局；强调辅助生殖技术的核心支撑作用。生育力保存的临床实施需依托妇科肿瘤、生殖医学、病理等多学科协作，在肿瘤学安全与生育需求间实现个体化平衡，同时面临技术普及不均、决策复杂性等挑战。未来需通过规范化诊疗推广、技术创新及社会支持体系完善，助力更多年轻患者在肿瘤治愈后实现生育愿望，彰显医学模式向“以患者为中心”的深刻演进。
Abstract：The younger onset of gynecological malignancies and the improvement of diagnosis and treatment levels have significantly enhanced the survival rate of early-stage patients. Preserving fertility has become a key focus in clinical practice, driving a shift in the treatment philosophy from "survival first" to "balancing quality of life". This article systematically reviews the fertility preservation strategies for early-stage cervical cancer, endometrial cancer, and ovarian-related malignancies: clarifying the core indications for fertility preservation in each tumor, elaborating on the core surgical and drug treatment plans for fertility preservation, and the oncological safety and pregnancy outcomes confirmed by related clinical studies; emphasizing the core supporting role of assisted reproductive technology. The clinical implementation of fertility preservation requires multidisciplinary collaboration among gynecological oncology, reproductive medicine, and pathology to achieve an individualized balance between oncological safety and fertility needs. However, it also faces challenges such as uneven technology dissemination and complex decision-making. In the future, through the promotion of standardized diagnosis and treatment, technological innovation, and the improvement of social support systems, more young patients will be able to realize their fertility wishes after tumor treatment, highlighting the profound evolution of the medical model towards a "patient-centered" approach.
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基本信息:
中图分类号:R737.3
引用信息:
[1]吴玉梅,魏佳慧.早期妇科肿瘤患者保留生育功能的现状、挑战与未来展望[J].中华保健医学杂志,2026,28(02):109-114.
基金信息:
首都卫生发展科研专项项目(首发2024-1-2112)
2026-02-28
2026-02-28