宫腔镜、腹腔镜联合应用在诊治子宫内膜癌中的临床效果观察

Clinical observation of hysteroscope and laparoscope combined application in diagnosis and treatment of endometrial cancer

目的观察宫腔镜、腹腔镜联合应用在子宫内膜癌诊治中的临床疗效。方法选取我院2014年10月～2018年2月收治的35例子宫内膜癌患者作为研究对象,按照随机双盲法分为宫腔镜组(19例)和诊刮组(16例),宫腔镜组采用宫腔镜检查,诊刮组采用诊刮术检查。评价两组的病理诊断符合率。根据采用手术方法的不同,将患者分为开腹手术组(17例)和腹腔镜手术组(18例),比较两组手术时间、术中出血量、淋巴结切除数、肛门排气时间、平均住院天数、膀胱功能恢复等临床指标及术后并发症的发生率。结果宫腔镜组的诊断准确率为94.74%(18/19)高于诊刮组的68.75%(11/16),差异有统计学意义(P<0.05)。腹腔镜手术组中出血量为(129.9±38.4)mL低于开腹手术组的(280.0±90.7)mL,差异有统计学意义(P<0.05)。腹腔镜手术组术后肛门排气时间(37.5±8.2)h低于开腹手术组的(55.4±9.0)h,差异有统计学意义(P<0.05)。两组的手术时间、术后住院时间、膀胱功能恢复时间比较,差异无统计学意义(P>0.05)。腹腔镜手术组并发症总发生率为11.11%,低于开腹手术组的41.18%,差异有统计学意义(P<0.05)。结论宫腹腔镜联合应用诊断子宫内膜癌的准确性高,且术中患者出血量少,恢复快,值得临床推广应用。

Objective To observe the clinical efficacy of hysteroscope and laparoscope combined application in diagnosis and treatment of endometrial cancer.Methods Thirty-five patients with endometrial cancer admitted to our hospital from October 2014 to February 2018 were enrolled in this study and were divided into hysteroscopy group(19 cases)and curettage group(16 cases)according to the randomized double-blind method.The hysteroscopy group was examined by hysteroscopy,and the curettage group was examined with a curettage.The pathological diagnosis coincidence rates of the two groups were evaluated.According to the different surgical methods,the patients were divided into open surgery group(17 cases)and laparoscopic surgery group(18 cases).The operation time,intraoperative blood loss,amounts of resected lymph nodes,time to anal exhaustion,average hospital stay,bladder function recovery,and incidence of postoperative complications were compared between the two groups.Results The diagnostic accuracy of the hysteroscopy group was 94.74%(18/19),which was higher than that of the curettage group(68.75%,11/16).The difference was statistically significant(P<0.05).The amount of bleeding in the laparoscopic surgery group was(129.9±38.4)mL,lower than that in the open surgery group[(280.0±90.7)mL],and the difference was statistically significant(P<0.05).The postoperative time to anal exhaustion in the laparoscopic surgery group[(37.5±8.2)h]was shorter than that in the open surgery group[(55.4±9.0)h],and the difference was statistically significant(P<0.05).There were no significant differences in the operation time,the average length of hospital stay,and the recovery time of bladder function between the two groups(P>0.05).The total incidence of complications in the laparoscopic surgery group was 11.11%,lower than that in the open surgery group(41.18%),and the difference was statistically significant(P<0.05).Conclusion The combined application of hysteroscope and laparoscope has many advantages such as higher accuracy,less blood loss,and faster recovery,which is thus worthy to be promoted.