腹腔镜下广泛子宫切除术联合盆腔淋巴结清扫术对早期宫颈癌患者手术时长及术后康复的影响
| 作者: |
1赵晓棠
1 驻马店市中心医院妇产科，河南 驻马店 463000 |
| 通讯: |
赵晓棠
Email: 2430314575@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.02.010 |
摘要
目的：探讨联合腹腔镜下广泛子宫切除术及盆腔淋巴结清扫术对早期宫颈癌患者手术时长及术后康复的影响。方法：选取2014年2月至2016年8月驻马店市中心医院74例早期宫颈癌患者，通过随机数字表法分为对照组与研究组(n=37)。研究组联合采用腹腔镜下广泛子宫切除术及盆腔淋巴结清扫术，对照组联合采用开腹广泛子宫切除术及盆腔淋巴结清扫术，术后随访3~6个月。统计对比两组手术情况(手术时长、术中失血量、淋巴结清扫数目)、术后康复情况(肛门排气时间、肛门排便时间、拔管时间、抗生素应用时间、住院时间)、入院时及术后3，6个月生活质量评分(Functional Assessment of Cancer Therapy-General，FACT-G)、并发症发生率。结果：研究组手术时长较对照组长，术中失血量较对照组少，淋巴结清扫数目较对照组多(P<0.05)；研究组肛门排气时间、肛门排便时间、拔管时间、抗生素应用时间、住院时间较对照组少(P<0.05)；术前两组FACT-G分值比较差异无统计学意义(P>0.05)，术后3，6个月研究组FACT-G分值较对照组高(P<0.05)；两组并发症发生率比较，研究组5.41%(2/37)较对照组24.32%(9/37)低(P<0.05)。结论：联合采用腹腔镜下广泛子宫切除术及盆腔淋巴结清扫术治疗早期宫颈癌效果显著，可有效减少手术创伤，促使术后机体功能康复，改善患者生活质量，且并发症较少，具有较高安全性。
关键词：
腹腔镜下广泛子宫切除术；盆腔淋巴结清扫术；早期宫颈癌；手术时长；术后康复
Effect of laparoscopic extensive hysterectomy combined with pelvic lymph node dissection on operation duration and postoperative rehabilitation of patients with early cervical cancer
CorrespondingAuthor: ZHAO Xiaotang Email: 2430314575@qq.com
DOI: 10.3978/j.issn.2095-6959.2018.02.010
Abstract
Objective: To investigate the effect of combined laparoscopic hysterectomy and pelvic lymphadenectomy on operation time and postoperative rehabilitation of patients with early cervical cancer. Methods: Seventy-four cases of early cervical cancer were randomly divided into a control group (n=37) and a study group (n=37) in our hospital from February 2014 to August 2016. The study group was treated with laparoscopic radical hysterectomy and pelvic lymph node dissection. The control group was treated with open hysterectomy and pelvic lymphadenectomy. All the cases were followed up for 3 to 6 months after operation. Two groups of surgery (surgical duration, intraoperative blood loss, number of lymph node dissection), postoperative rehabilitation (anal exhaust time, defecation time, extubation time, antibiotics time, hospitalization time), quality of life score [Functional Assessment of Cancer Therapy-General (FACT-G)] of 3 and 6 months at admission and after surgery, and the complication rate were statistically compared. Results: The duration of the study group was longer than that of the control group, the number of blood loss was less than that of the control group, and the number of lymph node dissection was more than that of the control group (P<0.05). The time of anal exhaust, anal defecation time, extubation time, antibiotic application time and hospital stay in the study group were less than those of the control group (P<0.05). There was no significant difference in FACT-G scores between the two groups before operation (P>0.05), and the scores of FACT-G in the study group were higher than those in the control group at 3 months and 6 months after the operation (P<0.05). Complication rates between the two groups were compared. The study group 5.41% (2/37) was lower than that of the control group 24.32% (9/37) (P<0.05). Conclusion: Laparoscopic radical hysterectomy combined with pelvic lymphadenectomy is effective in the treatment of early cervical cancer. It can effectively reduce the surgical trauma, promote the rehabilitation of the postoperative organism function, improve the quality of life of the patients, and have fewer complications with higher safety.
Keywords：
laparoscopic extensive hysterectomy; pelvic lymph node dissection; early cervical cancer; operation duration; postoperative rehabilitation