早期宫颈癌患者根治术后并发盆腔淋巴囊肿的危险因素

Risk factors of pelvic lymphocyst in patients with early cervical cancer after radical operation

目的研究早期宫颈癌患者根治术后并发盆腔淋巴囊肿的危险因素。方法回顾性分析2019年9月至2023年1月驻马店市中心医院收治的289例早期宫颈癌患者的临床资料,所有患者均进行宫颈癌根治术,其中56例术后并发盆腔淋巴囊肿者作为观察组,233例术后未并发盆腔淋巴囊肿者作为对照组。比较两组患者的临床资料,采用多因素Logistic回归分析法分析早期宫颈癌患者根治术后并发盆腔淋巴囊肿的危险因素。结果观察组患者临床分期为Ⅱa期、手术方式为开腹、使用器械为单极电刀、合并糖尿病、淋巴结切除范围为盆腔+腹主动脉旁、引流时间>7 d、盆腔淋巴结清扫数>20枚、术后辅助化疗和术后辅助放疗者的占比明显高于对照组,血清血红蛋白(Hb)水平则明显低于对照组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,临床分期为Ⅱa期、手术方式为开腹、使用器械为单极电刀、合并糖尿病、淋巴结切除范围为盆腔+腹主动脉旁、引流时间>7 d、盆腔淋巴结清扫数>20枚、术后辅助进行化疗、血清Hb水平≤110 g/L均为早期宫颈癌术后发生盆腔淋巴囊肿的独立危险因素(P<0.05)。结论早期宫颈癌术后发生盆腔淋巴囊肿的独立危险因素较多,临床可据此对其进行针对性治疗或干预,降低其术后发生盆腔淋巴囊肿的风险。

Objective To study the risk factors of pelvic lymphocyst in patients with early cervical cancer after radical operation.Methods The clinical data of 289 patients with early cervical cancer admitted to Zhumadian Central Hospital from September 2019 to January 2023 were retrospectively analyzed.All patients underwent radical hysterecto-my,including 56 patients with pelvic lymphocyst after operation as the observation group and 233 patients without pel-vic lymphocyst as the control group.The clinical data of the two groups were compared,and the risk factors of pelvic lymphocyst in patients with early cervical cancer after radical operation were analyzed by multivariate Logistic regres-sion analysis.Results In the observation group,the proportions of patients with clinical stage ofⅡa,the surgical meth-od of laparotomy,instrument of unipolar electrotome,diabetes mellitus,pelvic lymph node resection range of pelvic cavi-ty+abdominal aorta,drainage time>7 d,number of pelvic lymph node dissection>20,postoperative adjuvant chemothera-py,and postoperative adjuvant radiotherapy were significantly higher than those in the control group,while the serum he-moglobin(Hb)levels were significantly lower than those in the control group,with statistically significant differences(P<0.05).The results of multivariate Logistic regression analysis showed that the clinical stage ofⅡa,the surgical meth-od of laparotomy,the instrument of unipolar electrotome,complication of diabetes mellitus,lymph node resection range of pelvic cavity+abdominal aorta,drainage time>7 d,number of pelvic lymph node dissection>20,postoperative adju-vant chemotherapy,and the serum Hb level≤110 g/L were all independent risk factors for pelvic lymphocyst in patients with early cervical cancer after radical operation(P<0.05).Conclusion There are many independent risk factors for pelvic lymphocyst in patients with early cervical cancer after radical operation.Targeted clinical treatment or interven-tion can be carried out to reduce the risk of pelvic lymphocyst after surgery.