腹腔镜与开腹手术治疗早期子宫内膜癌临床分析

Clinical Analysis on Laparoscopic and Open Surgery in the Treatment of Endometrial Carcinoma Early Stage

[目的]比较腹腔镜与开腹手术治疗早期子宫内膜癌的围手术期情况及生活质量。[方法 ]对100例早期子宫内膜癌患者,按照其手术方式不同分为观察组及对照组。观察组54例患者均行腹腔镜手术,对照组46例患者均行开腹手术。对两组患者围手术期指标、术后并发症、性功能以及术后生活质量恢复情况进行观察与对比。[结果]观察组患者在手术时间方面略高于对照组,但差异无统计学意义(P>0.05)。其他围手术期指标如术中出血量、术后排气时间、下床活动时间及出院时间方面,观察组均远远优于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率为7.41%,对照组为41.30%,观察组远低于对照组,差异有统计学意义(P<0.05);术后观察组患者性功能评分与术前比较无显著差异(P>0.05),对照组患者性功能评分明显下降,与术前比较有统计学差异(P<0.05),且手术后两组间比较差异有统计学意义(P<0.05)。观察组患者生活质量改善率为59.26%,远远高于对照组患者的32.61%,两组相比差异有统计学意义(P<0.05)。[结论 ]腹腔镜与开腹手术治疗早期子宫内膜癌效果相当,但腹腔镜手术安全性高,术后性功能及生活质量改善情况较好,值得临床推广应用。

[Objective ] To investigate the quality of life （QOL） and perioperative data of laparo- scopic and open surgery in the treatment of endometrial carcinoma early stage. [Methods] One hundred cases with endometrial carcinoma undergoing surgery were selected and divided into ob- servation group and control group according to the methods of surgery ：54 cases in observation group underwent laparoscopic surgery;46 cases in control group underwent open surgery. The pe- rioperative indexes,complications,sexual function and QOL in two groups were compared. [Re- sults I Operation time in observation group were higher than that in control group without signifi- cant difference （P〉0.05）, but the other perioperative indexes such as blood loss, exhaust time, ac- tivity time and hospital stays in the observation group were obviously better than those in control group,with significant significance （t~〈0.05）. The complication rate of observation group was 7.41% ,which was obviously lower than that of control group （41.30%,P〈0.05）. The sexual func- tion of observation group after operation had no difference with that before operation （P〉0.05）, and it decreased significanthy in control group after operation compared with that before operation （P〈0.05）;and there was significant difference between two groups after operation（P〈0.05）. The im- provement rate of QOL in observation group was 59.26% ,which was higher than that in control group （32.61% ,P〈0.05）. [Conclusion] Compared with open surgery,laparoscopic surgery has similar effect for patients with endometrial carcinoma early stage, but it has better safety and im- provement of sexual function and QOL.