宫颈癌根治手术440例分析  

Evaluation on the operative situations of radical hysterectomy in 440 cervical cancer patients

作　　者：高京海[1] 于海林[1] 张雯碧[1] 朱芝玲[1] 鹿欣[1] 

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《肿瘤》2008年第11期986-989,共4页Tumor

摘　　要：目的:探讨宫颈癌根治术的手术情况。方法:对440例行宫颈癌根治术患者的临床及手术情况进行回顾性分析。结果:患者的平均年龄为43.9岁(范围:21～78岁),体质量指数的均数为23.2(范围:15.8～47.3)kg/m2。患者病理类型为:鳞癌353例(80.2%),腺癌56例(12.7%),腺鳞癌20例(4.6%),其他病理类型11例(2.5%)。根据国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期标准:Ⅰ期患者314例(71.4%),Ⅱ期126例(28.6%)。手术平均时间为221 min(范围:90～410 min),术中平均出血量为697 mL(范围:80～2 300mL)。有148例患者接受了输血,平均输血量为825 mL(200～2 300 mL)。87例(19.8%)患者术后病理提示淋巴结转移,淋巴转移的平均数为2.1个(1～5个),而脉管内转移的患者为83例(18.9%)。患者平均住院时间为26 d(9～57 d)。术后有并发症发生的为145例患者(32.9%):包括尿潴留、伤口感染、淋巴囊肿、深静脉血栓,其中残余尿量>100 mL者为125例,术后发热患者为73例。结论:本院施行的宫颈癌根治手术在宫颈癌治疗方面取得了较好的疗效。Objective ：To analyze the clinical and operative situations of radical hysterectomy in 440 cervical cancer patients. Methods：The clinical and operative situations were retrospectively evaluated in 440 cervical cancer patients. All the patients received radical hysterectomy and pelvic lymphadenectomy by the Wertheim-Okabayashi procedure. Results：The average age of the patients was 43.9 （21-78） years old and the mean body mass index （BMI） was 23.2 （15.8-47.3） kg/m^2. Histologie classification included： 353 cases （80.2%） of squamous cell carcinoma, 56 （ 12.8% ） cases of adenoearcinoma, 20 （4.6%） cases of adeno-squamous carcinoma, and 11 （2.5%） cases of other types. According to International Federation of Gynecology and Obstetrics （FIGO） staging standard, 314 （71.4%） cases were at stage Ⅰ and 126 （28.6%） cases were at stage Ⅱ , respectively. The mean operation time was 221 （90-410） min and the average blood loss was 697 （80-2 300） mL. One hundred and forty eight patients received blood transfusion with an average volume of 825 （200-2 300） mL. 87 patients （ 19.8% ） had lymph node metastasis, and the average number of positive lymph nodes was 2.1 （1-5）. 83 patients （18.9% ） had lymph-vascular space involvement （LVSI）. The patients stayed in hospital for 26（9-57） days. Post surgery complications occurred in 145 women （32.9%）. They included urine retention, wound infection, lymphocyst, and deep-vein thrombosis （DVT）. One hundred and 25 patients had more than 100 mL of post-void residual urine volume （PVR） , and 73 patients got fever after surgery. Conclusions：Radical hysterectomy and pelvic lymphadenectomy performed in our hospital achieved better clinical outcome in the treatment of cervical cancer.

关 键 词：宫颈肿瘤 外科手术 预后 

分 类 号：R737.33[医药卫生—肿瘤]