子宫颈癌根治术后并发症分析(附300例报告)  

Analysis of Postoperative Complications of Radical Hysterectomy for Cervical Cancer:A Report of 300 Cases

作　　者：夏蛮[1,2] 薛敏[1] 唐迪红[2] 张克强[2] 陈志明[2] 刘艳琼[2] 

机构地区：[1]中南大学湘雅三医院妇产科,长沙410013 [2]湖南省肿瘤医院妇瘤科,长沙410013

出　　处：《中国现代手术学杂志》2009年第2期134-136,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨子宫颈癌根治术后并发症及其预防措施。方法回顾性分析2002年1月至2007年1月收治的300例子宫颈癌根治术患者的临床资料,其中未保护盆腔自主神经者181例,术前辅助化疗128例,术前放疗102例。结果本组术后并发症发生率为28.3%(85/300),其中尿潴留44例(14.7%),盆腔淋巴囊肿29例(9.7%),腹壁切口5例(1.7%),阴道残端出血3例(1.0%),输尿管瘘2例(0.7%),肺部感染1例(0.3%),下肢静脉栓塞1例(0.3%)。术前辅助化疗者并发症发生率为29.7%(38/128),未行辅助化疗者为27.3%(47/172),两者比较无统计学差异(P>0.05);术前辅助放疗和未行放疗者并发症发生率分别为29.4%(30/102)和27.8%(55/198),两者比较无统计学差异(P>0.05);保留盆腔自主神经和未保留盆腔自主神经患者术后排尿功能障碍发生率分别为4.2%(5/119)和21.5%(39/181),两者比较具有显著统计学差异(P<0.05)。结论保留盆腔植物神经的子宫颈癌根治术可减少排尿功能障碍发生,术前新辅助放化疗与否对其并发症发生无影响。Objective To investigate the postoperative complications of radical hysterectomy and its pre- vention and therapeutic measures. Methods From January 2002 to January 2007, the clinical data of 300 cervical cancer eases underwent radical hysterectomy were reviewed. Among them, 119 eases obtained pelvic autonomic nerve preservation, 128 cases received preoperative adjuvant chemotherapy, and 102 cases under- went preoperative radiotherapy. Results The postoperative complication rate was 28.3% （85/300）. The post- operative complications were as follows ： 44 of urinary dysfimetion, 29 of lymphocyst, 5 of incisional wound infec- tion, 3 of residual vaginal bleeding, 2 of ureterostoma, 1 of pulmonary infection , anti 1 of lower limbs venous em- bolism. Tile postoperative complication incidence was 29.7% （38/128） and 27.3% （47/172） in patients re- ceived preoperative adjuvant chemotherapy or not respectively, was 29.4% （30/102） and 27.8% （55/198）in pa- tients underwent preoperative radiotherapy respectively or not respectively, and there was also no statistic differ- ence between them（ P 〉 0.05 ）. The urinary dysfunction rate was 4.2% （5/119 ） in patients with pelvic autonomic nerve preservation, and was obviously lower than 21.5% （39/181） of the patients without pelvic autonomic nerve preservation （P 〈 0.05）. Conclusions The radical hysterectomy with pelvic autonomic preservation can re- duce the rate of urinary dysfunction for cervical cancer. Preoperative neoadjuvant chemotherapy and preoperative afterloaded radiotherapy may not increase postoperative complication incidence.

关 键 词：子宫颈肿瘤 子宫切除术 手术后并发症 放射疗法 辅助 化学疗法 辅助 

分 类 号：R737.33[医药卫生—肿瘤]