宫腹腔镜联合诊治32例子宫内膜癌的临床分析

Clinical analysis of hysteroscopy combined with laparoscopy in diagnosis and treatment of 32 cases of endometrial carcinoma

目的探讨宫腔镜联合腹腔镜技术诊治子宫内膜癌的临床应用价值。方法对32例子宫内膜癌患者采用腹腔镜联合宫腔镜进行诊治的临床资料进行回顾性分析,评价宫腹腔镜联合手术的方法及效果。结果宫腔镜组与诊刮组子宫切除术前与术后病理诊断符合率分别为94.1%及66.7%(P<0.01);在早期子宫内膜癌诊断中,宫腔镜组和诊刮组的准确性分别为91.6%和58.3%(P<0.05);腹腔镜组与开腹组术中出血量分别为(115.8±75.3)ml和(276.7±100.2)ml(P<0.01);两组术后肛门排气时间分别为(36.2±8.1) h和(53.5±9.2)h(P<0.01)。结论宫腔镜检查并定位活检诊断子宫内膜癌准确性高;腹腔镜手术能达到与开腹手术一样的效果,并有损伤小、恢复快的优点,为临床提供了一种新的术式选择。

Objective To explore the clinical application value of hysteroscopy combined with laparoscopy operation in the diagnosis and treating endometrial carcinoma. Methods The clinical data of 32 cases of laparoscopy combined with hysteroscopy operations was analysed retrospectively. To evaluate of the surgical methods and effect in hysteroseopy combined with laparoscopy operation, Results The pathologic diagnosis accordance rate of hysteroscopy group and Dilatations and curettages group after operation were 94. 1% and 66. 7% respectively （P 〈0. 01 ） ;The aceuraey of hysteroscopy group and Dilatations and curettages group in the early - stage of endometrial carcinoma patients diagnosed were 91.6% and 58.3% respectively （P 〈0. 05） ;The mean estimated blood loss in the laparoseopy group was （115.8 ±75.3） ml and that in laparotomic group was （276, 7 ±100. 2） ml （P 〈0. 01 ） ;The mean postoperative gastrointestinal recovery time in laparoscopic group was （38.6± 8.5 ） hours, which was （51.6 ±8.6 ） hours in laparotomic group （ P 〈 0. 01 ）. Conclusion The accuracy of hysteroscopy used in the diagnosis of endometrial carcinoma is good. laparoscopy operation can acquire the same effectiveness to laparotomic operation, because of its minor trauma, quicker recovery, there are a new operation way to choose.