减少妇科恶性肿瘤术中出血及术后并发症的探讨

Study on the managements of reducing bleeding in operations of gynecologic malignant neoplasms

目的 通过对 6 1例妇科恶性肿瘤手术分析 ,着重探讨了术中出血和处理方法以及减少术后并发症。方法 1993年 7月至 1998年 6月对 6 1例妇科恶性肿瘤患者 (卵巢癌 32例 ,子宫内膜癌 2 3例 ,宫颈癌 6例 )施行了较彻底手术。患者年龄平均 5 2岁 (18～ 71岁 )。术中对不同部位的血管损伤及出血采取了相应的处理方法。结果 术中平均出血量 42 0～ 5 0 5ml ,血管损伤的 6例患者平均出血 75 0ml。手术时间平均 3 .0 8～ 3 .5 5小时。术后病率 6例 ,低钾血症 3例 ,淋巴囊肿 2例。术后恢复或至放、化疗开始时间 8.5～ 10 .2 5天。术中出血大于 6 0 0ml组 ,术后病率 2 6 .7% ,。较对照组明显增加 (P <0 .0 1)。结论 妇科恶性肿瘤术中出血的有效处理对减少并发症和术后及时有效的治疗有一定的临床意义。

Objective To discuss surgical bleeding and management related with complications in gynecologic malignant diseases.Methods 61 patients suffered from ovarian,endometrial and cervical cancers underwent operations from July 1993 to June 1998.The mean age was 52 years(range 18—71).Different methods were used to cope with various vessel damages.Results Mean blood lose during operations was 420～505ml and 750ml in 6 vessel damages.Mean operative time was 3.08～3.55 hours.After operations there were 6 cases of fever,3 low kalemias,2 lymphatic cysts.Average hospitalizations or the time radiotherapy or chemotherapy began was 8.5～10.25 days after operation.Patients whose blood lose over 600ml during operations had a significant high fever rate (26.7%)(P<0.01).Conclusions Efficient management of blood lose in gynecologic malignanacy operations was significant in reducing complications and facilitating following therapes. [