宫颈癌根治术后盆腔淋巴囊肿的预防与治疗

Prevention and treatment of pelvic lymphocyst after radical hysterectomy

目的:探讨宫颈癌根治术后盆腔淋巴囊肿的预防与治疗。方法:对宫颈癌根治术后246例患者随机采用烟卷引流管经阴道引流126例(研究组)及引流管经腹引流120例(对照组)进行对比研究。对34例淋巴囊肿患者按囊肿大小分为两组,A组:囊肿≤5cm 18例;B组:囊肿>5cm 16例,均采用中药外敷治疗;对囊肿较大者在B超监测下穿刺抽液后中药外敷治疗。结果:宫颈癌根治术后经阴道烟卷引流与经腹引流淋巴囊肿发生率的差异有统计学意义(P<0.01);囊肿≤5cm 18例中药布袋外敷治疗有效17例(94.44%);囊肿>5cm中10例穿刺引流后中药外敷治疗有效9例与6例未穿刺治疗相比差异有统计学意义(P<0.05)。结论:经阴道引流明显减少盆腔淋巴囊肿的发生;中药袋外敷治疗囊肿疗效肯定;囊肿体积较大者,穿刺引流后中药袋外敷治疗效果更好。

Objective:To analyze the prevention and treatment of pelvic lymphocyst after radical hysterectomy. Methods: 1. Study of prevention: 246 cervical cancer patients after radical hysterectomy were divided randomly into research group (126 cases using per vagina drainage With cigarette drain), and control group (120 cases using per abdomen drainage with drainagetube). 2. Study of treatment: 34 postoperation patients with pelvic lymphocyst undergoing external use of traditional Chinese medicine were divided into two groups by the size of cyst, group A: ≤5cm 18 cases, group B:>5cm 16 cases; for the bigger cyst, puncture drainage was performed under the guide of B ultrasound. Results: 1. Study of prevention: The morbility of pelvic lymphocyst between the study group and control group had significant difference in statistical index(P<0.01); 2. External use of traditional Chinese medicine was effective in 17 patients (94.44%) in group A; In group B, 10 cases used puncture drainage and 6 cases didn't use, the statistical index of the former and the latter was significant difference (P<0.05). Conclusion: Per vagina drainage can decrease the morbility of pelvic lymphocyst significantly; the effect of external use is certain; for bigger cyst, using puncture drainage before traditional Chinese medicine could have better effect.