阴式广泛全子宫切除术联合腹腔镜盆腔淋巴切除治疗子宫恶性肿瘤的效果

Effect of radical hysterectomy combined with laparoscopic pelvic lymphadenectomy on uterinemalignancy

目的:观察阴式广泛全子宫切除术联合腹腔镜盆腔淋巴切除治疗子宫恶性肿瘤的效果。方法:以2014年5月至2016年11月收治的子宫恶性肿瘤患者185例为研究对象,随机分为观察组93例和对照组92例,观察组患者给予阴式广泛全子宫切除术联合腹腔镜盆腔淋巴切除治疗,对照组患者给予常规开腹手术治疗。比较两组患者的手术时间、术中出血量、切除淋巴结数目、术后肛门排气时间、术后住院时间以及并发症发生率。结果:观察组患者的术后肛门排气时间短于对照组(t=15.394,P=0.000)、术后住院时间短于对照组(t=7.934,P=0.008);两组患者的手术时间比较,差异无统计学意义(t=2.136,P=0.528);观察组患者术中出血量少于对照组(t=16.327,P=0.000);两组患者淋巴结切除数目比较,差异无统计学意义(t=3.015,P=0.106);术后1个月,观察组患者并发症发生率为3.23%(3/93),低于对照组的11.96%(11/92)(χ~2=7.136,P=0.021)。结论:采用阴式广泛全子宫切除术联合腹腔镜盆腔淋巴切除治疗子宫恶性肿瘤,具有创伤小、恢复快、并发症少等优点,值得推广应用。

Objective： To observe the effect of radical hysterectomy combined with laparoscopic pelvic lymphadenectomy on uterinemalignancy. Methods： 185 patients with uterinemalignancy from May 2014 to November 2016 were divided into the observation group（ 93 cases） and the control group（ 92 cases）. The patients in the observation group were treated with radical hysterectomy combined with laparoscopic pelvic lymphadenectomy while the patients in the control group were treated with conventional laparotomy,with the operation time,perioperative bleeding,the number of resected lymph nodes,postoperative anal exhaust time,postoperative hospital stay and the incidence rate of the complications compared. Results： The postoperative anal exhaust time of the patients in the observation group was shorter than that in the control group（ t = 15. 394,P = 0. 000）; the hospital stay in the observation group was shorter than that in the control group（ t = 7. 934,P = 0. 008）.There was no significant difference in the operation time and the number of resecting lymph nodes between the two groups（ t = 2. 136,3. 015; P = 0. 528,0. 106）.The perioperative bleeding of the patients in the observation group was less than that in the control group（ t = 16. 327,P = 0. 000）; the incidence rate of the complications in the observation group was 3. 23 %,which was less than that of the control group（ 11. 96 %）（ χ2= 7. 136,P = 0. 021）. Conclusion： Radical hysterectomy combined with laparoscopic pelvic lymphadenectomy has some advantages such as minimal trauma,rapid recovery and fewer complications,worthy of promotion and application.