腹腔镜下子宫广泛性切除术在Ⅰa2～Ⅱb期子宫颈癌患者中的应用效果

Therapeutic effects of laparoscopic hysterectomy on cervical cancer in stageⅠa2～Ⅱb

目的探讨腹腔镜下行子宫广泛性切除术在Ⅰa2～Ⅱb期子宫颈癌患者中的应用效果。方法选择接诊的行腹腔镜下子宫广泛性切除术子宫颈癌患者49例为研究组,选取同期接受诊治行开腹手术子宫切除术子宫颈癌患者46例为对照组。研究组行腹腔镜下子宫广泛性切除术,对照组采取开腹下广泛性子宫切除,观察2组患者的手术时间、盆腔引流量、住院时间、肛门排气时间、以及停留导尿管时间;对2组患者治疗后进行电话随访以及复查,比较2组患者并发症发生情况。结果研究组患者的手术时间长于对照组,盆腔引流量和肛门排气时间明显短于对照组(P <0. 05),研究组患者出现切口脂肪液化愈合不良、感染、淋巴囊肿、输尿管瘘发生例数少于对照组,但差异无统计学意义(P> 0. 05),研究组中出现尿潴留少于对照组,差异有统计学意义(P <0. 05)。研究组卵巢癌患者在治疗后,血清中CA125、TNF-α及SIL-2R水平均明显下降,低于对照组,差异有统计学意义(P <0. 05),对照组总有效率为43. 48%明显低于研究组的69. 39%,差异有统计学意义(P <0. 05)。结论腹腔镜下进行子宫广泛性切除术治疗Ⅰa2～Ⅱb期子宫颈癌患者,安全性较高,术后并发症较少,值得推广。

Objective To observe the therapeutic effects of laparoscopic hysterectomy on cervical cancer in stage Ⅰa2~Ⅱb. MethodsForty-nine patients with cervical cancer who underwent uterine extensive resection under laparoscope in our hospital from January 2015 to June 2016 were enrolled in the study as research group,meanwhile, the other 46 patients with cervical cancer who underwent laparotomy hysterectomy were enrolled as control group.The operation duration, pelvic drainage volume, hospitalization time,anal exhaust time and catheter retention time were observed for both groups,moreover, the patients in both groups were followed up, and the incidence rates of complications were observed and compared between two groups. ResultsThe operation duration in research group was longer than that in control group,however, the pelvic drainage volume and anal exhaust time were significantly shorter than those in control group (P<0.05). The incidence rates of poor healing due to incision fat liquefaction,infections,lymphatic cyst, ureteral fistula and urine retention in research group were significantly lower than those in control group ( P >0.05). After treatment, the serum levels of CA125,TNF-a and SIL-2R in research group were significantly decreased,as compared with those in control group ( P <0.05),moreover, the total effective rate in control group was significantly lower than that in research group (43.48% vs 69.39%, P <0.05). Conclusion The laparoscopic hysterectomy in treatment of cervical cancer in stage Ⅰa2~Ⅱb has the advantages of higher safety and less postoperative complications,therefor,which is worth using widely in clinical practice.