宫颈癌根治术后腹部切口脂肪液化的原因分析及治疗

The Reason Analysis and Treatment of Abdominal Incisional Fat Liquefaction after Radical Hysterectomy in Cervical Cancer

目的:探讨宫颈癌根治术后切口脂肪液化发生的相关危险因素和治疗对策。方法:回顾性行宫颈癌广泛全子宫切除术+盆腔淋巴结清扫术523例,对可能影响切口脂肪液化发生的相关因素进行统计学分析,并对常规治疗和50%葡萄糖联合金因肽治疗切口脂肪液化效果进行比较。结果:切口脂肪液化的发生率为9.37%(49/523);年龄>60岁、有糖尿病史、腹部脂肪厚度>5 cm、电切+电凝开腹方法和手术时间>2.5 h的患者腹部切口脂肪液化的发生率明显升高,差异均有统计学意义(P<0.05);试验组疗效明显优于对照组,两者比较差异有统计学意义(P<0.05)。结论:年龄>60岁、有糖尿病史、腹部脂肪厚度>5 cm、电切+电凝开腹方式和手术时间>2.5 h是腹部切口脂肪液化的高危因素;50%葡萄糖联合金因肽治疗切口脂肪液化疗效确切,简单易行,可在临床推广使用。

Objective To discuss the related risk factors and treatment of abdominal incisional fat liquefaction after radical hysterectomy in cervical cancer. Method 523 patients who received radical hysterectomy ＋ pelvic lymph node dissection were analyzed by retrospective review. The related risk factors of incisional fat liquefaction were analyzed by statistics,and the curative effect in conventional therapy was compared with the treatment of 50% glucose combine with epidermal growth factor. Results The rate of incisional fat liquefaction was 9. 37%（49/523）; The patients who had diabetes,the abdominal subcutaneous fat thickness 5 cm,the laparotomy method for electroresection ＋ electrocoagulation and the time of operation 2. 5 h,had a high occurence rate of incisional fat liquefaction,the differences were statistically significant（P〈0. 05）. The curative effect in experimental group was remarkably better than that of control group,and the differences were statistically significant（P〈0. 05）. Conclusion Diabetes,the abdominal subcutaneous fat thickness 5 cm,the laparotomy method for electroresection ＋electrocoagulation and the time of operation 2. 5 h,were the high risk factors of incisional fat liquefaction; the treatment of 50%glucose combine with epidermal growth factor have obvious curative effect,is simple and easy to generalize in clinical practice.