胚原单位性子宫切除术在子宫颈癌治疗中的临床应用价值研究

Clinical application of hysterectomy of primordial unit in the treatment of cervical cancer

目的探讨胚原单位性子宫切除在局部早期子宫颈癌中的安全性、可行性及其预后分析。方法选取2017年1月至2022年6月因子宫颈癌[国际妇产科联盟(FIGO)分期ⅠB1、ⅠB2、ⅡA1期]于大连医科大学附属第二医院进行手术治疗的263例患者,以在个体发育的胚胎学理论指导下行胚原单位性子宫切除的子宫颈癌患者119例作为研究组,另有前期接受传统广泛子宫切除手术患者144例作为对照组。比较两组的术中出血量、手术时间、血红蛋白变化情况、术后住院时间、手术相关并发症、术后随访情况等。结果两组患者的年龄、体重指数以及各项临床和病理特征比较差异无统计学意义(P>0.05);研究组术中出血量、血红蛋白下降值明显少于对照组(P<0.05);研究组输血治疗发生率少于对照组(P<0.05);研究组术后住院时间与对照组无明显差异(P>0.05);研究组手术时间较对照组长(P<0.05);研究组手术相关并发症发生率低于对照组(8.40%vs.25.00%P<0.05)。结论胚原单位性子宫切除较传统广泛性子宫切除术在早期子宫颈癌手术治疗中可有效改善各项手术指标,促进患者恢复,并发症发生风险较低,具有安全性和有效性,值得临床推广可应用。

Objective To investigate the safety,feasibility,and prognostic analysis of hysterectomy of primordial unit in locally early-stage cervical cancer.Methods A total of 263 patients with cervical cancer(FIGO stagesⅠB1,ⅠB2,and ⅡA1)who underwent surgical treatment at the Second Affiliated Hospital of Dalian Medical University from Janu-ary 2017 to June 2022 were selected.Among them,119 patients with cervical cancer who underwent hysterectomy of primordial unit guided by the embryological theory of individual development were included as the study group.Additionally,144 patients who had previously undergone traditional extensive hysterectomy were included as the control group.A comparison was made between the two groups regarding intraoperative bleeding,surgical duration,changes in hemoglobin levels,postoperative hospital stay,surgical complications,and follow-up outcomes after surgery.Results There were no statistically significant differences(P>0.05)in age,body mass index,or various clinical and pathological characteristics between the two groups.The study group had significantly less intraoperative bleeding and decreased hemoglobin levels compared to the control group(P<0.05).The incidence of blood transfusion therapy was lower in the study group than in the control group(P<0.05).There was no significant difference in postoperative hospital stay between the study group and the control group(P>0.05).The study group had a longer surgical duration compared to the control group(P<0.05).The incidence of surgical complications was lower in the study group than in the control group(P<0.05).Conclusions Hysterectomy of primordial unit is an effective approach in the surgical treatment of early-stage cervical cancer,offering significant improvements in various surgical parameters compared to traditional extensive hysterectomy.It promotes patient recovery with a lower risk of complications and is safe and effective.Hysterectomy of primordial unit has better local tumor control after operation.Therefore,it is worthy of clinical adoption and promotion.