不同术式治疗子宫恶性肿瘤的临床效果、淋巴清除效果及并发症发生率分析

摘要

Objective To investigate the clinical effect,lymph removal effect and complication rates of different operative methods for treatment of uterine malignant tumor.Methods Eighty two patients with malignant tumor were selected as objection from February 2014 to January 2014.The research objects were divided into control group and observation group via operation method.Control group were given open widely uterus resection treatment and pelvic lymph node cleaning,and the observation group were given laparoscopic treatment of extensive hysterectomy combined with pelvic lymph node cleaning.The intraoperative blood loss,operation time anal exhaust time,length of stay,expenses,lymph node and complications were observed.Results The operation time 165.34 ± 20.16min and intraoperative blood loss 196.57 ± 21.48ml in observation group were lower than the control group 234.16-± 25.35min,311.55 ± 26.75ml (P ＜0.01).The anal exhaust time 42.14 ±5.36h,hospitalization time 9.71 ± 1.89d ays and expenses 19317.28 ±2163.52 yuan in observation group were obvious lower than control group 45.25-± 7.83h,(12.16 ± 2.15)days,24538.78 ± 2461.71 yuan(P ＜ 0.05).The lymph node cleaning number in observation group(28.76 ± 4.11) was higher than control group (20.14 ± 5.32) (P ＜ 0.01).The complications were mainly for urinary retention,lymphocele,wound infection and vascular injury.The complication rates 17.07％ (7/41)in observation group was lower than control group 8.64％ (17/41) (x2 =4.870,P =0.027).Conclusion The laparoscopic hysterectomy combined with pelvic lymph node cleaning treatment on uterine malignant tumor have good clinical effect,have good lymph node removal effect,and low complications.It was economic and safe for clinical application.%目的 探讨不同术式对子宫恶性肿瘤的临床疗效、淋巴清除效果及并发症发生率的影响.方法 选择2014年2月～ 2016年1月在笔者医院接受手术治疗的82例子宫恶性肿瘤患者为研究对象,根据手术方法将患者分为对照组(41例)和观察组(41例),对照组患者给予开腹广泛性子宫切除术及盆腔淋巴结切除术,观察组患者给予腹腔镜下广泛性子宫切除手术和盆腔部位淋巴结清扫手术,观察手术时间、术中出血量、肛门排气、住院费、住院时间和淋巴节,观察患者的并发症.结果 观察组患者的手术时间为165.34±20.16min、术中出血量为196.57 ±21.48ml,明显低于对照组的234.16±25.35min、311.55±26.75ml(P＜0.01).观察组患者的肛门排气时间为42.14±5.36h、住院时间为9.71±1.89天、住院费为19317.28±2163.52元均显著低于对照组的45.25±7.83h、12.16 ±2.15天、24538.78±2461.71元,差异有统计学意义(P＜0.05).观察组患者的清扫淋巴结数为28.76±4.11,明显高于对照组的20.14±5.32(P ＜0.01).两组患者术后并发症主要为淋巴囊肿、尿潴留、伤口感染和血管损伤等,观察组并发症的发生率为17.07％ (7/41),明显低于对照组的38.64％(17/41,x2=4.870,P=0.027).结论 腹腔镜下广泛性子宫切除术和盆腔淋巴结清扫术治疗子宫恶性肿瘤临床效果良好,淋巴清除效果好,安全性好,费用低,临床值得广泛推广应用.