早期子宫内膜癌患者行腹腔镜手术后疗效及术后性功能的临床研究

摘要

目的：探究早期子宫内膜癌患者行腹腔镜手术治疗的临床疗效及对术后性功能的影响。方法选择2013年3月至2015年7月于灌云县中医院妇科住院治疗的90例早期子宫内膜癌患者为研究对象，45例采用腹腔镜手术治疗为观察组，45例采用传统开腹手术治疗为对照组，比较两组的临床疗效及术后性功能变化情况。结果两组患者手术时间及术中淋巴结清扫数量差异无统计学意义（P＞0.05）；观察组患者术后肛门排气时间[（32.19±3.27）h]、下床活动时间[（51.45±6.76）h]、住院时间[（9.89±2.17）d]、术中出血量[（307.82±87.96）mL]、术后盆腹腔引流量[（478.94±65.43）mL]及并发症发生率（6.67％）均少于对照组[（52.34±5.47）h、（92.29±12.34）h、（13.23±2.89）d、（594.37±125.68）mL、（795.66±78.32）mL、26.67％]，（P＜0.05）。两组患者术前性功能评分相近（P＞0.05）；观察组患者术后6个月性功能评分与术前相近（P＞0.05）；对照组患者术后6个月性功能评分低于术前（P＜0.05）。结论早期子宫内膜癌采用腹腔镜手术治疗具有创伤小、术后恢复快、减少并发症的发生以及对患者术后性功能影响小等优点，值得临床推广应用。%Objective To investigate the clinical effect of laparoscopic operation on early stage endometrial cancer and the influence on sexual function .Methods A total of 90 patients with early cancer of endometrium who hospitalized in Department of gynecology of traditional Chinese medicine hospital of Guanyun County from March 2013 to July 2015 were selected and divided into observation group and control group , with 45 patients in each group .Traditional operation were conducted in the control group , while the observation group used laparoscopic operation , and the clinical effect and changes in sexual function were compared between the two groups.Results The observation group had similar operative time and number of lymph nodes cleared in the operation compared to the control group, and the differences were statistically insignificant (P>0.05);the postoperative time of passage of gas by anus [(32.19 ±3.27)h], postoperative time to out-of-bed activity [(51.45 ±6.76) h], postoperative length of stay [(9.89 ±2.17) d], intraoperative blood loss[(307.82 ±87.96)mL], postoperative drainage volume of abdominopelvic cavity [(478.94 ±65.43)mL] and incidence of complications(6.67 %)of the observation group were less than those of the control group [(52.34 ±5.47)h、(92.29 ± 12.34)h、(13.23 ±2.89)d、(594.37 ±125.68)mL、(795.66 ±78.32)mL、26.67 %],(P <0.05).Before the operations, the patients of the two groups had similar Brief Index of Sexual Function for Women ( BISF -W) scores, and the differences were statistically insignificant ( P >0.05 ) .But 6 months after the operation the control group had lower scores than those before the operation, and the differences were statistically significant (P<0.05).Conclusion Laparoscopic operation in treatment of early stage endometrial cancer has good clinical effects with smaller wound and rapid recovery .It can reduce the incidenle of complications and effectively protect sexual function of the patients , thus is worthy of clinical application .