患者升温系统联合S-100吸收性止血绫在子宫内膜癌分期术中淋巴管残端封堵的应用效果观察

Observation on Application Effect of Patient Warming System+S-100 Absorbable Stanching Satin in theOcclusion of Lymphatic Vessel Stumps During Endometrial Cancer Staging Surgery

目的:探究患者升温系统联合S-100吸收性止血绫在子宫内膜癌分期术中淋巴管残端封堵的应用效果。方法:选取2018年1月~2020年1月于本院收治的60例子宫内膜癌Ⅰ期患者为研究对象,使用随机数字表法分为对照组(n=30)和观察组(n=30)。对照组患者术中仅放置吸收性明胶海绵局部止血,观察组患者术中使用升温系统与ASS对淋巴管残端封堵。探究两组患者术后淋巴液总量、拔除引流管时间、是否需要补充白蛋白、补充白蛋白量区别,比较两组患者术前及术后3d时炎症反应(C反应蛋白、中性粒细胞计数)差异,比较两组患者术后并发症发生差异。结果:观察组术后淋巴液总量、拔除引流管时间、补充白蛋白率、补充白蛋白量分别为(168.53±41.05)mL、(5.80±1.12)d、6.67%、(3.33±0.69)g,均低于对照组的(1177.03±254.17)mL、(8.06±1.78)d、80.00%、(82.67±21.04)g(P均<0.05)。术后3d时,两组患者CRP、中性粒细胞计数水平与术前相比均上升,但观察组[(17.73±4.12)mg/L、(5.58±1.11)×10^(9)/L]低于对照组[(23.83±5.36)mg/L、(7.72±1.44)×10^(9)/L](P均<0.05)。两组患者术后并发症发生差异不显著(P均>0.05)。结论:患者升温系统联合S-100吸收性止血绫应用于子宫内膜癌分期术中淋巴管残端封堵时,明显减少患者术后引流量,缓解术后炎症反应,推测可降低淋巴囊肿形成的几率。

Objective:To Explore the application effect of patient heating system combined with S-100 absorbable hemostatic gauze(ASS)in lymphatic stump occlusion during endometrial cancer staging surgery.Methods:60 patients with stage I endometrial cancer treated in our hospital between January 2018 and January 2020 were selected as the research subjects,and they were divided into control group(n=30)and observation group(n=30)by using the random number table method.Patients in control group only placed absorbable gelatin sponge for local hemostasis during surgery,and patients in observation group applied warming system during surgery and ASS to block the stump of the lymphatic vessel.The differences in total postoperative lymphatic fluid,drainage tube removal time,presence or absence of albumin supplementation and albumin supplementation amount were explored in the two groups of patients and differences in inflammatory response[C-reactive protein(CRP),neutrophil count]were compared between the two groups before surgery and at 3d after surgery.The occurrence of postoperative complications of the two groups were compared.Results:The total postoperative lymphatic fluid,drainage tube removal time,albumin supplementation rate and albumin supplementation amount of(168.53±41.05)mL,(5.80±1.12)d,6.67%and(3.33±0.69)g in observation group were less or shorter than(1177.03±254.17)mL,(8.06±1.78)d,80.00%and(82.67±21.04)g in control group(all P<0.05).At 3d after surgery,the levels of CRP and neutrophil count in the two groups were increased compared with those before surgery,but the levels of[(17.73±4.12)mg/L,(5.58±1.11)×10^(9)/L]in observation group were lower than[(23.83±5.36)mg/L,(7.72±1.44)×10^(9)/L]in control group(all P<0.05).There were no significant differences in the occurrence of postoperative complications between the two groups(P>0.05).Conclusion:Patient warming system combined with S-100 absorbable hemostatic gauze for the occlusion of lymphatic vessel stumps during endometrial cancer staging surgery can significantly reduce the postoperative drainage volume,and relieve postoperative inflammatory response.Presumably,it can reduce the probability of lymphocyst formation.