腹腔镜下广泛子宫切除盆腔淋巴结清扫术治疗早期宫颈癌与开腹手术临床对比分析.docVIP

腹腔镜下广泛子宫切除盆腔淋巴结清扫术治疗早期宫颈癌与开腹手术临床对比分析 　　[摘要] 目的 对比RAH与LRH+LPL治疗ICC的效果。方法 方便选取2014年7月―2017年7月该院妇科治疗的60例ICC患者按不同的术式分为LRH+LPL组、RAH组，LRH+LPL组31例，RAH组29例；治疗后比较康复指标、并发症。结果 RAH组尿管保留（13.95±2.68）d，盆腔引流（5.88±0.37）d，下床活动（50.57±5.29）h，排气（47.65±8.42）h，住院（13.36±4.21）d；LRH+LPL组尿管保留（10.72±7.21）d，盆腔引流（2.03±0.05）d，下床活动（33.41±7.75）h，排气（35.07±5.96）h，住院（8.55±2.06）d。LRH+LPL组并发症率12.92%，RAH组并发症率34.50%。LRH+LPL组康复指标显著优于RAH组，并发症率明显低于RAH组。结论 LRH+LPL治疗ICC的效果优于RAH。 　　[关键词] 腹腔镜；开腹；宫颈癌 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）12（b）-0051-03 　　[Abstract] Objective To compare the effect of RAH and LRH+LPL in treatment of ICC. Methods 60 cases of ICC patients treated in our hospital from July 2014 to July 2017 convenient were selected and divided into LRH+LPL group with 31 cases， RAH group with 31 cases and LRH+LPL group with 31 cases and RAH group with 29 cases， and the recovery indexes and complications after treatment were compared. Results The retention of urethral catheter， pelvic draining， out-of-bed activity， exhaust and hospitalization in the RAH group and LRH+LPL group were respectively （13.95±2.68）d， （5.88±0.37）d， （50.57±5.29）h， （47.65±8.42）h， （13.36±4.21）d and （10.72±7.21）d， （2.03±0.05）d， （33.41±7.75）h， （35.07±5.96）h， （8.55±2.06）d， and the complication rate in the LRH+LPL group and RAH group was respectively 12.92% and 34.50%， and the recovery indicators in the LRH+LPL group were obviously better than those in the RAH group， and the complication rate was obviously lower than that in the RAH group. Conclusion The effect of LRH+LPL in treatment of ICC is better than that of RAH. 　　[Key words] Laparoscopic； Laparotomy； Cervical carcinoma 　　?m颈癌发病与HPV感染、吸烟、性激素分泌失调、早孕及早婚等有关，我国每年新发病例可达10万人左右，低龄化发病趋势明显。宫颈癌灶浸润深度、浸润范围可影响治疗策略制定、预后情况，随着肿瘤分期进展，可形成新生血管与加快肿瘤生长浸润，治疗策略也将随之调整。早期宫颈癌（ICC）盆腔内淋巴结的转移率可达15%以上，多采用手术治疗ICC。治疗时应采用安全彻底、恢复快的手术方法，避免切除正常的淋巴结，减轻手术操作对血管神经、阴道、输尿管、直肠、膀胱造成的损伤，减少术后淋巴结或切缘阳性、宫旁浸润等复发因素，使ICC预后良好[1]。该文方便选取2014年7月―2017月7月收治60例ICC患者对比分析了腹腔镜下广泛子宫切除（LRH）和盆腔淋巴结清扫术（LPL）治疗ICC与开腹手术（RAH）的临床效果，现报道如