腹腔镜下广泛子宫切除术联合盆腔腹主动脉旁淋巴结清扫术治疗子宫内膜癌的临床效果观察

Clinical effect of laparoscopic extensive hysterectomy and pelvi cparaaortic lymph node dissection in the treatment of endometrial carcinoma

目的:探讨腹腔镜下广泛子宫切除术联合盆腔腹主动脉旁淋巴结清扫术治疗子宫内膜癌的临床效果。方法:选取2016年4月—2021年6月甘肃中医药大学第三附属医院收治的96例子宫内膜癌患者,随机数字表法分为研究组和对照组各48例。对照组患者采用常规开腹手术治疗,研究组患者采用腹腔镜下广泛子宫切除术联合盆腔腹主动脉旁淋巴结清扫术治疗。比较两组患者肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)指标、残余尿量、排尿量、平均尿流率、术中出血量、淋巴结清除数量、术后并发症情况、健康调查简表(SF-36)评分、复发率。结果:手术前、后,两组的TNF-α、CRP、IL-6指标比较,差异无统计学意义(P>0.05)。手术后,研究组残余尿量少于对照组,差异有统计学意义(P<0.05);研究组排尿量和平均尿流率多于对照组,差异有统计学意义(P<0.05)。研究组术中出血量少于对照组,差异有统计学意义(P<0.05);两组淋巴结清除数量比较,差异无统计学意义(P>0.05)。手术后,研究组并发症总发生率(6.25%)低于对照组(22.92%),差异有统计学意义(P<0.05)。术后1个月,研究组复发率(4.17%)低于对照组(20.83%);SF-36评分高于对照组,差异均有统计学意义(P<0.05)。结论:给予子宫内膜癌患者腹腔镜下广泛子宫切除术联合盆腔腹主动脉旁淋巴结清扫术治疗效果显著,可有效减少术后并发症发生风险,复发情况较少,患者预后良好,值得临床应用。

Objective To investigate the clinical effect of laparoscopic extensive hysterectomy and pelvic paraaortic lymph node dissection in the treatment of endometrial carcinoma.Methods 96 patients with endometrial cancer treated in the Third Affiliated Hospital of Gansu University of traditional Chinese medicine from April 2016 to June 2021 were retrospectively analyzed.The patients were randomly divided into study group and control group,with 48 cases in each group.Patients in the control group were treated with conventional open surgery,while patients in the study group were treated with laparoscopic hysterectomy and pelvic paraaortic lymph node dissection.Comparison of tumor necrosis factor between the two groups-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)index,residual urine volume,micturition volume,average urinary flow rate,intraoperative bleeding volume,number of lymph node clearance,postoperative complications,SF-36 score and recurrence rate.Results Before operation,TNF in both groups-α.There was no significant difference between CRP and IL-6(P>0.05).After operation,the residual urine volume in the study group was less than that in the control group(P<0.05);The urinary output and mean urinary flow rate of the study group were higher than those of the control group(P<0.05).The amount of intraoperative bleeding in the study group was less than that in the control group(P<0.05);There was no significant difference in the number of lymph nodes removed between the two groups(P>0.05).After operation,the incidence of complications in the study group(6.25%)was significantly lower than that in the control group(22.92%).The difference was statistically significant(P<0.05).One month after operation,the recurrence rate in the study group(4.17%)was lower than that in the control group(20.83%);The SF-36 score was significantly higher than that of the control group(P<0.05).Conclusion Laparoscopic extensive hysterectomy and pelvic paraaortic lymph node dissection for endometrial cancer patients can effectively control the risk of cancer progression and postoperative complications,with less trauma,less bleeding,less impact on bladder function,less recurrence,and good prognosis.It is worthy of clinical application.