开腹手术与腹腔镜手术对早期子宫内膜癌术后下肢深静脉血栓形成的影响

Effect of laparotomy and laparoscopic surgery on the formation of lower extremity deep vein thrombosis after early endometrial cancer surgery

目的探讨开腹手术与腹腔镜手术对早期子宫内膜癌术后下肢深静脉血栓(DVT)形成的影响。方法收集2019年10月至2021年10月于石家庄市人民医院接受手术治疗的102例早期子宫内膜癌患者的临床资料,根据手术方式不同将患者分为开腹组(采取开腹手术)和腹腔镜组(采取腹腔镜手术),各51例。比较两组患者的手术情况、术后住院期间相关指标。结果腹腔镜组患者的手术时间长于开腹组患者,术中出血量少于开腹组患者,术后排气时间、术后尿管留置时间及术后住院时间均短于开腹组患者(P﹤0.05)。两组患者的术中腹膜后淋巴结切除数目比较,差异无统计学意义(P﹥0.05)。术后住院期间,腹腔镜组患者下肢DVT的发生率、D-二聚体水平及D-二聚体水平升高的患者比例均低于开腹组患者(P﹤0.05)。结论腹腔镜手术可缩短早期子宫内膜癌患者的手术时间、术后排气时间、术后尿管留置时间及术后住院时间,减少术中出血量,降低术后下肢DVT的发生风险,促进患者早期恢复。

Objective To investigate the effect of laparotomy and laparoscopic surgery on the formation of lower extremity deep vein thrombosis(DVT)in patients with early endometrial cancer after surgery.Method The clinical data of 102 patients with early endometrial cancer who underwent surgical treatment in the Shijiazhuang People's Hospital from October 2019 to October 2021 were collected,according to different surgical methods,all patients were divided into laparotomy group(laparotomy)and laparoscopic group(laparoscopic surgery)with 51 cases in each group.The surgical conditions and postoperative hospital stay-related indicators were compared between the two groups.Result The surgery time of the laparoscopic group was shorter than that of the laparotomy group,the amount of intraoperative blood loss was less than that of the laparotomy group,the postoperative exhaust time,postoperative urinary catheter indwelling time and postoperative hospital stay were shorter than those of the laparotomy group(P<0.05).There was no significant difference in the number of intraoperative retroperitoneal lymph node resections between the two groups(P>0.05).During postoperative hospitalization,the incidence rate of lower extremity DVT,the level rate of D-dimer,and the proportion of patients with elevated D-dimer levels in the laparoscopic group were lower than those in the laparotomy group,the differences were statistically significant(P<0.05).Conclusion Laparoscopic surgery could shorten the surgery time,postoperative exhaust time,postoperative urinary catheter indwelling time,and postoperative hospital stay in patients with early endometrial cancer.This method would also reduce intraoperative blood loss,reduce the risk of postoperative low extremity DVT,and promote early recovery of patients.