目的 探讨腹腔镜与开腹手术治疗早期卵巢癌的临床疗效.方法 回顾性分析2012年1月至2015年1月期间湛江中心人民医院妇产科收治的86例早期卵巢癌患者的临床资料,根据手术方法的不同将42例腹腔镜手术患者纳入观察组,44例开腹手术者纳入对照组,分别于术前(T0)、术后即刻(T1)、术后24 h(T2)测定患者血清超敏C反应蛋白(hs-CRP)水平,比较两组患者围手术期指标及随访期间复发情况.结果 术后T1、T2时刻观察组血清hs-CRP水平分别为(29.6±8.4)mg/L、(32.8±10.1)mg/L,均明显低于对照组的(35.4±10.3)mg/L、(39.7±12.6)mg/L,差异均有统计学意义(P<0.05);观察组患者的手术时间为(252.4±26.9)min,明显长于对照组的(201.5±32.7)min,差异有统计学意义(P<0.05);观察组患者术中出血量为(116.2±31.2)mL,明显少于对照组的(215.9±43.8)mL,淋巴结清扫个数为(35.2±11.4)个,多于对照组的(22.4±9.2)个,术后排气时间为(36.4±11.5)h,短于对照组的(49.2±13.7)h,以上各项指标比较差异均有统计学意义(P<0.05);观察组患者术后并发症发生率为7.14%,明显低于对照组的22.73%,差异有统计学意义(P<0.05);随访18个月,观察组和对照组患者术后复发率分别为9.52%和6.82%,差异无统计学意义(P>0.05).结论 腹腔镜手术治疗早期卵巢癌可获得与开腹手术相同的临床效果,并且具有应激反应轻、出血量少、术后并发症发生率低等优势.%Objective To investigate the clinical efficacies of laparoscopy and laparotomy in the treatment of early ovarian cancer. Methods The clinical data of 86 cases of early ovarian cancer patients, who admitted to Department of Obstetrics and Gynecology of Zhanjiang Central People's Hospital from January 2012 to January 2015, were reviewed retrospectively. According to the different surgical methods, these patients were divided into in the observation group (42 cases of laparoscopic surgery) and the control group (44 cases of abdominal surgery). The levels of serum high sensitivity C reactive protein (hs-CRP) were measured before operation (T0), immediately after operation (T1), and 24 h after operation (T2). The perioperative indicators and recurrence during follow-up were compared between the two groups. Results The serum hs-CRP in the observation group at T1 and T2 were (29.6±8.4) mg/L and (32.8±10.1) mg/L respectively, which were significantly lower than corresponding (35.4 ± 10.3) mg/L and (39.7 ± 12.6) mg/L of the control group (P<0.05). The operation time of the observation group was (252.4±26.9) min, which was significantly longer than (201.5±32.7) min of the control group (P<0.05). The blood loss, number of resected lymph nodes, postoperative exhaust time were respectively (116.2 ± 31.2) mL, (35.2 ± 11.4), (36.4 ± 11.5) h in the observation group versus corresponding (215.9 ± 43.8) mL, (22.4 ± 9.2), (49.2 ± 13.7) h in the control group (all P<0.05). The postoperative complications rate of the observation group was 7.14%, which was significantly lower than 22.73%of the control group (P<0.05). After 18 months of follow-up, there was no significant difference in the postoperative recurrence rate between the observation group (9.52%) and the control group (6.82%), P>0.05. Conclusion Laparoscopic surgery can get the same clinical effect as open surgery in the treatment of early stage ovarian cancer, which also has the advantages of less bleeding, light stress response and lower incidence of postoperative complications.
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