腹腔镜下子宫全切除联合盆腔淋巴结清扫术治疗高龄宫颈癌患者的临床效果及安全性分析

Clinical Efficacy and Safety of Laparoscopic Total Hysterectomy Combined with Pelvic Lymphadenectomy in the Treatment of Elderly Patients with Cervical Cancer

目的 探讨选择腹腔镜下子宫全切除术+盆腔淋巴结清扫术对高龄宫颈癌患者治疗后获得的临床效果以及安全性。方法选择该院2016年8月—2018年12月收治的88例高龄宫颈癌患者作为实验对象;数字奇偶法分组后明确各组手术方式;对照组(44例):选择根治性开腹子宫全切除术方法展开治疗;观察组(44例):选择腹腔镜下子宫全切除术+盆腔淋巴结清扫术展开治疗;对比手术效果以及安全性。结果 观察组宫颈癌患者术中失血量为(301.49±58.59)mL,首次排便时间为(3.51±1.11)h,首次排气时间为(2.29±0.59)h,住院时间为(11.19±2.41)d,拔管时间为(3.25±1.25)d;对照组宫颈癌患者术中失血量为(403.39±46.79)mL,首次排便时间为(5.62±1.29)h,首次排气时间为(3.62±1.29)h,住院时间为(15.09±3.43)d,拔管时间为(5.99±1.65)d;观察组宫颈癌患者术中失血量少于对照组明显(t=9.014 7,P<0.05);观察组宫颈癌患者首次排便时间、首次排气时间、住院时间以及拔管时间均短于对照组明显(t=8.224 2,6.219 3,6.171 1,8.780 1,P<0.05);观察组宫颈癌患者手术不良反应总发生率(6.82%)低于对照组(31.82%)明显(χ~2=8.821 9,P<0.05)。结论 高龄宫颈癌患者在接受手术期间,腹腔镜下子宫全切除术+盆腔淋巴结清扫术的有效应用,对于术中失血量减少,首次排便时间、首次排气时间、住院时间以及拔管时间缩短,术后副反应减少,均发挥显著作用,最终对于高龄宫颈癌患者的康复加快,奠定基础。

Objective To investigate the clinical effect and safety of laparoscopic total hysterectomy plus pelvic lymphadenectomy in the treatment of elderly patients with cervical cancer. Methods A total of 88 elderly patients with cervical cancer admitted to our hospital from August 2016 to December 2018 were selected as experimental subjects. The operation modes of each group were defined after dividing them by digital parity method. The control group(44 cases) received radical laparotomy hysterectomy treatment;while the observation group (44 cases) received laparoscopic hysterectomy + pelvic lymphadenectomy treatment. Effectiveness and safety were compared. Results In the observation group, the intraoperative blood loss was (301.49±58.59)mL, the first bowel movement time was (3.51±1.11)h, the first exhaust time was (2.29±0.59)h, the hospitalization time was (11.19±2.41)d, and the extubation time was (3.25±1.25)d. In the control group, the intraoperative blood loss was (403.39±46.79)mL, the first bowel movement time was (5.62±1.29)h, the first exhaust time was (3.62±1.29)h, the hospitalization time was (15.09±3.43)d, and the extubation time was (5.99±1.65)d. The intraoperative blood loss of cervical cancer patients in the observation group was significantly lower than that in the control group (t=9.014 7,P<0.05). The first defecation time, the first exhaust time, the hospitalization time, and the extubation time of the cervical cancer patients in the observation group were shorter than those in the control group(t=8.224 2, 6.219 3, 6.171 1, 8.780 1,P<0.05). The total incidence of surgical side reactions in patients with cervical cancer in the observation group (6.82%) was significantly lower than that in the control group (31.82%)(χ^2=8.821 9,P<0.05). Conclusion The effective application of laparoscopic total hysterectomy plus pelvic lymphadenectomy in elderly patients with cervical cancer during the operation period plays a significant role in reducing intraoperative blood loss, shortening the first defecation time, the first exhaust time, hospitalization time and extubation time, and reducing the postoperative side effects. Finally, it lays a foundation for speeding up the rehabilitation of elderly patients with cervical cancer.