腹腔镜下根治性子宫切除术治疗宫颈癌的效果

Clinical effect of laparoscopic radical hysterectomy for treating cervical cancer

目的:探究腹腔镜下根治性子宫切除术治疗宫颈癌的临床效果及并发症。方法:回顾性分析2013年7月-2018年7月本院手术治疗的宫颈癌患者120例临床资料,其中经腹腔镜下子宫切除术(LRH)60例,经腹根治性子宫切除术(ARH)60例。比较两组临床效果和并发症以及术后患者生活质量。结果:LRH组住院时间(7.4±2.1d)、术中出血量(81.0±8.1ml)、术后排气时间(28.1±4.3h)、下床活动时间(5.1±1.1h)均低于ARH组(P<0.05);两种术后卵泡刺激素、雌二醇及黄体生成素均较术前提高但组间无差异(P>0.05)。两组术后3个月生活质量评分较术前均提高,且LRH组评分(89.11±7.32分)高于ARH组(64.16±6.17分)(P<0.05)。LRH组感染率(1.7%)、膀胱损伤率(1.7%)、5年随访肿瘤复发率(25.0%)和生存率(60.0%)与ARH组比较无差异(P>0.05)。结论:宫颈癌行腹腔下根治性子宫切除术或经腹根治性子宫切除术均可有效提高患者性激素水平,减少并发症,手术效果相当,肿瘤复发率和死亡率未见差异,LRH手术后恢复时间更短,生活质量更佳。

Objective:To investigate the clinical effect and complications of laparoscopic radical hysterectomy for treating women with cervical cancer.Methods:The clinical data of 120 women with cervical cancer from July 2013 to July 2018 were analyzed retrospectively,which included 60 women treated by laparoscopic hysterectomy(LRH)in study group and 60 women treated by radical abdominal hysterectomy(ARH)in control group.The clinical effect,complication rate,and postoperative quality of life of women were compared between the two groups.Results:The hospital stay time,intraoperative blood loss,postoperative exhaust time,and out-of-bed time of women in the study group were 7.4±2.1d,81.0±8.1ml,28.1±4.3h,and 5.1±1.1h,respectively,which were significant shorter than those of women in the control group(P<0.05).The levels of FSH,estradiol,and luteinogen had increased significantly after operation,but which had no significant difference between groups(P>0.05).The quality of life score of women had increased significantly 3 months after the operation,and the score of the women in study was 89.11±7.32 points,which was significant higher than that(64.16±6.17 points)of women in the control group(P<0.05).The rates of infection,bladder injury and tumor recurrence,and survival rate of women in the study group were 1.7%,1.7%,25.0%,and 60.0%,respectively,which had no significant different from those of women in the control group(P>0.05).Conclusion:Both LRH and ARH for treating women with cerical cancer have the similar clinical efficacy,tumor recurrence and mortality,which can increase the level of estrogen significantly and reduce the complications,However,the recovery time after LRH treatment is shorter and the quality of life is better.