子宫内膜癌的临床病理分析和腹腔镜手术治疗的疗效观察

Clinical Pathology Analysis and Efficacy of Laparoscopic Surgery of Endometrial Cancer

目的探讨子宫内膜癌的临床病理特点和腹腔镜手术治疗的临床疗效。方法选择2012年1月至2013年12月上海市第十人民医院接收的80例子宫内膜癌患者作为研究对象,将行开腹手术治疗的30例患者作为对照组,另外实施腹腔镜手术治疗的50例患者作为试验组,分析子宫内膜癌患者的临床病理结果,并比较试验组与对照组患者的临床疗效进行分析。结果病理类型主要以腺癌为主,手术前后病理类型一致,符合率为92.5%(74/80)。试验组术中出血量少于对照组[(127±42)m L比(268±76)m L],手术时间、抗生素使用时间、住院时间短于对照组[(139±23)min比(187±84)min,(26±12)h比(38±17)h,(9.4±2.1)d比(14.8±4.2)d],差异均有统计学意义(P<0.05);两组术中淋巴结清扫数量、术后排气时间、留置导尿管时间、术后2 d体温比较差异无统计学意义(P>0.05)。结论腹腔镜手术治疗子宫内膜癌较开腹手术可以明显地减少术中出血量、缩短手术时间、抗生素使用时间以及住院时间,有利于患者的术后恢复,临床疗效显著,安全可行,是临床治疗子宫内膜癌的有效途径。

Objective To evaluate the clinical pathologic features and efficacy of laparoscopic surgery of endometrial cancer.Methods A total of 80 cases of endometrial cancer in Shanghai Tenth People′s Hospital from Jan.2012 to Dec.2013 were included in the study,30 patients who underwent open surgery as the control group and another 50 patients who underwent laparoscopic surgery as the trial group,the clinical pathology of patients with endometrial cancer were analyzed and the clinical efficacy of the two groups were com-pared.Results Pathology was mainly adenocarcinoma which was consistent with the pathological type after surgery, and the rate was 92.5%（74/80）.Intraoperative blood loss of the experimental group was less than that of control group [（127 ±42） mL vs （268 ±76） mL],and operation time, antibiotics use time, hospi-talization time were shorter than those of control group [（139 ±23） min vs （187 ±84） min,（26 ±12） h vs （38 ±17） h,（9.4 ±2.1） d vs（14.8 ±4.2） d],the difference was statistically significant （P 〈0.05）.The number of lymph nodes dissection , postoperative discharge time , catheterization indwelling time , post-operative hypothermia, postoperative complication rate of two groups were no significant differences （ P 〈0.05）.Conclusion Laparoscopic surgery for endometrial cancer compared with open surgery can signifi-cantly reduce blood loss,operative time,length of hospitalization and antibiotic use etc.,which is conducive to the recovery of patients with significant clinical effect ,good safety and feasibility,and is an effective way to treat endometrial cancer.