腹膜后淋巴引流对妇科恶性肿瘤手术患者术后淋巴囊肿及炎症应激状态的控制作用观察

Observation on the Control Effect of Retroperitoneal Lymphatic Drainage for the Postoperative Lymphocyst and Inflammatory Stress State of Patients with Surgery for Gynecological Malignant Tumors

目的:研究腹膜后淋巴引流对妇科恶性肿瘤术后淋巴囊肿及炎症应激状态的控制作用。方法:选取2017年6月-2019年3月本院收治的120例妇科恶性肿瘤手术患者为研究对象,根据治疗情况的不同将其分为对照组和观察组,每组60例。对照组未进行腹膜后淋巴引流,观察组进行腹膜后淋巴引流。比较两组术后淋巴囊肿发生率、感染发生率、手术前后的炎症应激指标。结果:观察组开腹手术术后淋巴囊肿发生率为3.31%,低于对照组的21.88%,差异有统计学意义(P<0.05);观察组腹腔镜手术术后淋巴囊肿发生率为3.57%,低于对照组的21.43%,差异有统计学意义(P<0.05);观察组术后淋巴囊肿总发生率为3.33%,低于对照组的21.67%,差异有统计学意义(P<0.05)。观察组术后感染总发生率为0,低于对照组的8.33%,差异有统计学意义(P<0.05)。术前两组TNF-α、PGE2、IL-6水平比较,差异均无统计学意义(P>0.05);术后1、3 d,两组的炎症应激指标均持续升高,差异均有统计学意义(P<0.05),但观察组TNF-α、PGE2、IL-6水平均显著低于对照组,差异均有统计学意义(P<0.05)。结论:腹膜后淋巴引流对妇科恶性肿瘤术后淋巴囊肿及炎症应激状态的控制作用相对较好,值得在妇科恶性肿瘤手术患者中推广应用。

Objective:To study the effect of retroperitoneal lymphatic drainage on the control of lymphocyst and inflammatory stress after gynecological malignant tumors.Method:A total of 120 cases of gynecological malignant tumor patients admitted to our hospital from June 2017 to March 2019 were selected as the research objects.They were divided into the control group and the observation group according to the treatment,60 cases in each group.The control group did not undergo retroperitoneal lymphatic drainage,the observation group underwent retroperitoneal lymphatic drainage.The incidence of postoperative lymphocyst,infection and inflammatory stress before and after surgery were compared between the two groups.Result:The incidence of lymphocyst after laparotomy in the observation group was 3.31%,lower than the 21.88% in the control group,the difference was statistically significant (P<0.05).The incidence of lymphocyst after laparoscopic surgery in the observation group was 3.57%,lower than the 21.43% in the control group,the difference was statistically significant (P<0.05).The total incidence of postoperative lymphocyst in the observation group was 3.33%,lower than the 21.67% in the control group,the difference was statistically significant (P<0.05).The overall incidence of postoperative infection in the observation group was 0,lower than the 8.33% in the control group,the difference was statistically significant (P<0.05).Preoperative levels of TNF-α,PGE2 and IL-6 were compared between the two groups,the differences were not statistically significant (P>0.05).1 day and 3 days after surgery,inflammatory stress indicators continued to rise in both groups,the differences were statistically significant (P<0.05).However,the levels of TNF-α,PGE2 and IL-6 in the observation group were significantly lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:Retroperitoneal lymphatic drainage plays a relatively good role in the control of lymphatic cysts and inflammatory stress after gynecological malignant tumor surgery,which is worthy to be popularized and applied in patients with gynecological malignant tumor surgery.