妇科肿瘤腹膜后淋巴结切除术后淋巴囊肿形成的相关因素分析  

Correlation analysis of the lymphocyst after retroperitoneal lymphadenectomy in the gynecological neoplasia patients

作　　者：姚远洋[1] 李云 王悦[1] 李艺[1] 唐军[1] 王建六[1] 魏丽惠[1] 

机构地区：[1]北京大学人民医院妇产科,北京100044 [2]北京市通州区第二医院妇产科,北京101102

出　　处：《现代妇产科进展》2013年第1期32-35,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨妇科肿瘤患者腹膜后淋巴结切除术后淋巴囊肿形成的相关因素及对临床的指导价值。方法:回顾性分析2010年7月至2011年6月北京大学人民医院妇科行腹膜后淋巴结切除术100例妇科肿瘤患者的临床资料,对患者术后淋巴囊肿形成的相关因素进行相关性分析。结果:65例患者术后出现淋巴囊肿。(1)引流方式、是否行腹腔化疗及血清白蛋白含量是影响淋巴囊肿形成的独立因素(P均<0.05)。(2)淋巴囊肿体积与是否关闭后腹膜及切除腹膜后淋巴结数量有关(P=0.025,0.011)。(3)65例淋巴囊肿患者中,14例有自觉症状(21.5%),10例出现并发症(15.4%)。结论:(1)经腹壁引流、减少不必要的腹腔化疗及纠正低蛋白血症可预防淋巴囊肿的形成。(2)术中开放后腹膜及减少切除腹膜后淋巴结数量可减小淋巴囊肿体积,进而降低并发症的风险。Objective：To explore the correlative factors of the lymphocyst formation after retroperitoneal lymphadenectomy in the gynecological neoplasia patients,and its value in clinical treatment.Methods：From July 2010 to June 2011,100 gynecological neoplasia patients who underwent retroperitoneal lymphadenectomy were involved in this study.Their clinical datas were analyzed retrospectively.Results：Lymphocysts were found in 65 patients.（1）Drainage way,intraperitoneal chemotherapy,and the level of serum albumin were the independent influencing factors of the lymphocyst formation（P0.05）.（2）The size of lymphocyst was correlated with the retroperitoneum closed or not,as well as the number of retroperitoneal lymph nodes removed（P=0.025,P=0.011）.（3）Among the 65 patients with lymphocyst,14 patients developed symptoms（21.5%）,and the complications were found in 10 patients（15.4%）.Conclusions：（1）Choosing transabdominal drainage,reducing the unnecessary intraperitoneal chemotherapy,and remedy the hypoproteinemia can prevent from the lymphocyst formation.（2）Leaving the retroperitoneum open and reducing the number of retroperitoneal lymph nodes that were removed can diminish the size of lymphocyst,and then decrease the incidences of complication.

关 键 词：腹膜后淋巴结切除术 妇科肿瘤 淋巴囊肿 引流方式 腹腔化疗 

分 类 号：R737.3[医药卫生—肿瘤]