摘要
［目的］探讨准确选择宫颈癌病人的手术范围。〔方法〕对 ２４２例宫颈癌进行手术治疗，其中 Ｉ类手术 ４例（ Ｉａ１期），Ⅱ类手术５例（Ｉａ１期），Ⅲ类手术１０４例（Ｉａ２、Ｉｂ１期及放疗后复发或未控），Ⅳ类手术１２５例（Ｉｂ２、Ｉｂ３、Ⅱａ、Ⅱｂ期及放疗后复发或未控者）， Ⅴ类及Ⅵ类手术各 ２例，均为复发癌。［结果］Ｉａ及 Ｉｂ１期 ５年生存率为 １００％，Ｉｂ２期 ５年生存率为９３．３３％， Ｉｂ３期为８８．３９％， Ⅱａ、 Ⅱｂ期５年生存率为８７．５０及７７．７８％。放疗后未控及复发癌的５年生存率为６２．３６％。手术主要并发症为泌尿道感染、膀胱功能障碍及输尿管瘘，其发生率随手术范围的扩大而增加。［结论］宫颈癌手术方式的选择，应针对每个病人治疗的需要，采取合适手术，既不盲目扩大，也不能无原则缩小。
Purpose] To choose the management method in cervical carcinoma accurately. [Method] Two hundred and forty-two patients with cervical carcinoma were treated surgically including class I operation 4 cases, class Ⅱ operation 5 cases, class Ⅲ operation 104 cases, class Ⅳ operation 125 cases, class Ⅴ and Ⅵ operations 2 cases with recurrent carcinoma respectively. [Results] 5 - year survival rate of patients with stage Ia.and Ib1 was 100%, that with stage Ib2、Ib3、Ⅱa、Ⅱb1 and recurrent carcinoma was 93.33%、 88.39%、 87.50%、 77.78% and 62.36% respectively. The main compli cations were urinary tract infection, bladder disfunction, and ureter fistula. [Conclusion] The choice of surgical modality should be individulized, neither blind extension nor unprincipled minimization.
