妇科肿瘤手术患者化疗后淋巴囊肿感染预防及治疗

Study on prevention and treatment of lymphocyst infection in postoperative chemotherapy for gynecologic malignants

目的探讨妇科肿瘤手术患者化疗后淋巴囊肿感染预防及治疗方法,以降低淋巴囊肿感染的发生。方法将184例妇科肿瘤术后化疗患者随机分为治疗组与对照组,每组各92例;所有患者均接受盆腔淋巴结切除术及CEF方案化疗,术后常规抗感染治疗,治疗组同时给予粒细胞集落刺激因子(G-CSF)治疗,比较患者淋巴囊肿发生及感染。结果化疗后治疗组与对照组淋巴囊肿的发生率分别为33.7%、32.6%,差异无统计学意义;治疗组淋巴囊肿的感染率16.1%,显著低于对照组43.3%,差异有统计学意义(χ2=5.42,P<0.05);治疗组患者的发热时间、中性粒细胞>1.5×109/L的时间较对照组显著缩短(P<0.05)。结论预防性使用抗菌药物辅以GCSF治疗,可有效降低妇科肿瘤患者术后化疗期间盆腔淋巴囊肿的感染率,改善患者预后。

OBJECTIVE To explore the prevention and treatment method of lymphocyst infection in postoperative chemotherapy for gynecologic malignants, in order to reduce the incidence of lymphocyst infection. METHODS A total of 184 patients undergoing postoperative chemotherapy for gynecologic malignants were randomly divided into two groups, treatment group and control group with 92 patients in each group. All the patients were given bilater-al pelvic lymph node dissection, chemotherapy with CEF and conventional anti-infection treatment after surgery. The treatment group was treated with granulocyte colony-stimulating factor （G-CSF） additionally. The incidence of lymphocyst and lymphocyst infection between the two groups were compared. RESULTS After chemotherapy, there were no significant difference on the incidence of lymphocyst between the two groups（33.7% vs 32.6 %）（P 〉0.05）, while the lymphocyst infection rate in treatment group （16. 1%） was significantly lower than that in control group （43.3%） X^2 =5.42, P〈0.05）. Compared with control group, the fever time and time to ANC〉 1.5× 10^9/L was remarkably shortened in treatment group （P〈0.05）. CONCLUSION Combination use of antibi- otic and G-CSF can effectively reduce lymphocyst infection in postoperative chemotherapy for gynecologic malig-nants, and improve patients prognosis.