宫颈癌腹腔镜手术疗效及影响预后的临床相关因素研究

Study on the clinical effect of laparoscopic surgery and prognosis of cervical cancer

目的:分析宫颈癌腹腔镜手术疗效及影响预后的临床相关因素。方法:选取我院2014年10月至2016年11月收治的宫颈癌患者120例,按随机数字表法分为观察组、对照组。观察组(60例)给予腹腔镜手术治疗,对照组(60例)给予开腹手术治疗。对比两组相关手术指标,并分析影响宫颈癌腹腔镜手术预后的临床相关因素。结果:观察组术中淋巴结清扫数(21.43±1.23)枚、术后3d白细胞计数(8.38±0.70)×109/L较对照组明显降低;观察组术后3d血红蛋白(109.02±6.22)×109/L和对照组比较明显升高(P<0.05);有盆腔淋巴结转移、有脉管瘤栓、>Ⅰb2期、深肌层浸润者的复发率与无盆腔淋巴结转移、无脉管瘤栓、≤Ⅰb2期、浅肌层浸润者的相比明显升高,5年内生存率与其相比明显降低(P<0.05);采用logistic回归分析发现,影响宫颈癌腹腔镜手术预后的临床相关因素主要为盆腔淋巴结转移、脉管瘤栓、临床分期、肌层浸润深度(P<0.05)。结论:宫颈癌腹腔镜手术治疗有一定的疗效,可有效提高血红蛋白等指标,同时发现盆腔淋巴结转移、临床分期、肌层浸润深度等情况可能会对其预后疗效产生一定的影响。

Objectives： To analyze the clinical effect of laparoscopic cholecystectomy and prognosis.Methods： 120 patients with cervical cancer in our hospital from October 2014 to November 2016 were divided into observation group and control group according to the random number table method. The observation group（ 60 cases） received laparoscopic surgery,and the control group（ 60 cases） received laparotomy. The relative surgery indexes of two groups were compared,and the clinical factors related to the prognosis of cervical cancer were analyzed. Results： The number of lymph node dissection（ 21. 43 ± 1. 23） and white blood cell count（ 8. 38 ± 0. 70）in observation group were significantly lower than these in control group after the operation. The hemoglobin in observation group（ 109. 02 ± 6. 22） was significantly higher than that in control group after the operation（ P 0. 05）. There was no significant difference between the two groups（ P 0. 05）. The recurrence rate of pelvic lymph node metastasis,vascular tumors bolt, Ib2 stage and myometrial invasion was significantly higher than that without the above symptoms（ P 0. 05）. Logistic regression analysis showed that the clinical factors related to the prognosis of cervical cancer were mainly pelvic cavity lymph node metastasis,portal vein thrombosis,clinical stage and depth of myometrial invasion（ P 0. 05）. Conclusion： Laparoscopic surgery for cervical cancer has a certain effect,which can effectively improve the hemoglobin and other indicators. The pelvic lymph node metastasis,clinical stage and depth of myometrial invasion may have a certain impact on its prognosis.