宫颈癌根治术后患者并发症发生的影响因素

Influencing factors of postoperative complications in patients with radical hysterectomy for cervical cancer

目的 分析宫颈癌(CC)根治术后患者并发症发生的影响因素。方法 回顾性收集2020年1月至2023年3月成都医学院第二附属医院·核工业四一六医院379例接受CC根治术患者的临床资料。依据术后是否发生并发症,将其分为并发症组、无并发症组。分析CC根治术后患者并发症发生的影响因素。结果 379例患者CC根治术后并发症发生率为20.32%(77/379)。两组年龄、合并糖尿病、合并高血压、学历、家庭年收入、绝经情况、盆腔手术史、病理分型、阴道切除长度、主韧带切除长度及鳞癌抗原、糖类抗原125水平比较,差异无统计学意义(P>0.05);两组体重指数(BMI)、肿瘤直径、临床分期、淋巴结转移、淋巴结清扫数目、淋巴管结扎、手术时间、术中出血量及血红蛋白(Hb)、血清白蛋白、C反应蛋白(CRP)、补体C3比较,差异有统计学意义(P<0.05)。BMI(OR=2.675)、临床分期(OR=3.350)、淋巴结转移(OR=3.010)、淋巴结清扫数目(OR=2.568)、手术时间(OR=2.442)、CRP(OR=3.093)为CC根治术后患者并发症发生的危险因素(P<0.05);淋巴管结扎是CC根治术后患者并发症发生的保护因素(OR=0.310,P<0.05)。结论 CC根治术后患者并发症主要类型为尿潴留、输尿管瘘、术后切口感染;BMI、临床分期、淋巴结转移、淋巴结清扫数目、手术时间、CRP为危险因素,淋巴管结扎为保护因素;临床可据此给予针对性的治疗或干预,降低患者术后并发症发生的风险。

Objective To analyze the influencing factors of postoperative complications in patients with radical hysterectomy for cervical cancer(CC).Methods The clinical data of 379 patients who received radical hysterectomy for CC in the Second Affiliated Hospital of Chengdu Medical College Nuclear Industry 416 Hospital from January 2020 to March 2023 were retrospectively collected.According to whether postoperative complications occurred,the patients were divided into complication group and non-complication group.The influencing factors of complications after radical hysterectomy for CC were analyzed.Results The complication rate of 379 patients after radical hysterectomy for CC was 20.32%(77/379).There were no significant differences in age,diabetes mellitus,hypertension,education background,family annual income,menopause,history of pelvic surgery,pathological classification,length of vaginal resection,length of principal ligament resection,and the levels of squamous cell carcinoma antigen and carbohydrate antigen 125 between two groups(P>0.05);there were significant differences in body mass index(BMI),tumor diameter,clinical stage,lymph node metastasis,number of lymph node dissection,lymph vessel ligation,operation time,intraoperative blood loss,hemoglobin(Hb),serum albumin,C-reactive protein(CRP),and complement C3 between two groups(P<0.05).BMI(OR=2.675),clinical stage(OR=3.350),lymph node metastasis(OR=3.010),number of lymph node dissection(OR=2.568),operation time(OR=2.442),and CRP(OR=3.093)were the risk factors for complications after radical hysterectomy for CC(P<0.05);lymphatic vessel ligation was a protective factor for complications after radical hysterectomy for CC(OR=0.310,P<0.05).Conclusion The main complications after radical hysterectomy for CC are urinary retention,ureteral fistula,and postoperative incision infection.BMI,clinical stage,lymph node metastasis,number of lymph node dissection,operation time,CRP are risk factors,lymph vessel ligation were protective factors.Therefore,clinical treatment or intervention can be given to reduce the risk of postoperative complications for patients.