不同术式治疗子宫恶性肿瘤围手术期恢复效果及并发症发生情况的对比分析

The effects of laparoscopic and open surgery on perioperative recovery and incidence of complications in patients with uterine malignant tumor

目的探讨腹腔镜与传统开放性子宫切除手术治疗子宫恶性肿瘤的临床效果、淋巴结清扫效果和并发症发生率。方法选取行子宫全切术的96例子宫恶性肿瘤患者作为研究对象,其中50例行腹腔镜子宫全切术联合淋巴结清扫术(腹腔镜组),46例行开腹子宫全切术联合淋巴结清扫术(开放组),分别比较两组的临床效果、淋巴结清扫效果和并发症发生情况。结果两组手术时间相比,差异无统计学意义(P﹥0.05);腹腔镜组术中出血量明显少于开放组,肛门排气时间和住院时间短于开放组,差异均有统计学意义(P﹤0.05);腹腔镜组和开放组的淋巴结清扫数目分别为(29.1±5.3)个和(20.3±4.1)个,差异有统计学意义(t=9.043,P﹤0.05);腹腔镜组并发症发生率低于开放组,差异有统计学意义(χ2=13.371,P﹤0.05)。两组疗效相比,腹腔镜组总有效率为92.0%,开放组总有效率为76.1%,差异有统计学意义(P﹤0.05)。结论腹腔镜下子宫切除术能够有效提高临床疗效,增加淋巴结清扫数目,降低并发症发生率,有利于改善患者预后,值得在临床上推广使用。

Objective To explore the clinical effect of laparoscopic and traditional open hysterectomy in the treatment of uterine malignant tumor, and compare the lymph node dissection rate and incidence of complications. Method96 cases of uterine malignant tumor patients administered with radical hysterectomy were included in the analysis, in which 50 cases underwent laparoscopic hysterectomy combined lymph node dissection（as laparoscopy group）, while another 46 cases received open hysterectomy combined lymph node dissection（as laparotomy group）, of which the clinical effects, lymph node dissection rates and incidences of complications were compared. Result The operative time was similar in the two groups（P〈0.05）; But less intra-operative blood loss, shorter flatus time and less hospital stay were observed in the laparoscopy group compared with laparotomy group（P〈0.05）; And the laparoscopic group had（29.1＋5.3）dissected lymph nodes, significantly more than that of the laparotomy group at（20.3＋4.1）（t=5.65, P〈0.05）; Besides, the incidence of complications was lower in laparoscopy group than that in laparotomy group（χ^2=13.371, P〈0.05）; The total response rate was 92.0% in laparoscopy group, and 76.1% in laparotomy group, with significant differences observed（P〈0.05）. Conclusion Laparoscopic hysterectomy can effectively improve the clinical efficacy, and increase the number of lymph node dissection, while reduce the incidence of complications, which helps to improve the prognosis for patients,showing significant clinical value.