腹腔镜手术治疗早期子宫恶性肿瘤的临床研究  

The clinical study of aparoscopy in patients with malignant uterine tumors in early stage

作　　者：夏梦[1] 刘军秀[1] 姚书忠[1] 柯佩琪[1] 何勉[1] 

机构地区：[1]中山大学附属第一医院,广州510080

出　　处：《新医学》2013年第1期15-18,共4页Journal of New Medicine

摘　　要：目的:探讨经腹腔镜手术途径治疗早期子宫恶性肿瘤的安全性、有效性、优越性。方法:27例需行根治性子宫切除或改良根治性子宫切除加盆腔淋巴结清除术的早期子宫恶性肿瘤患者,根据术式不同,分为腹腔镜组(49例)和开腹组(78例),对两组术中情况(包括手术时间、术中出血量、输血量及输血率,宫旁组织及阴道切除范围、盆腔淋巴结清除数目)及术后情况(盆腔引流量、肛门排气时间、体温恢复正常时间、静脉使用抗生素时间、尿管停留时间、住院时间、术后3～7 d白细胞计数)进行比较。结果:腹腔镜组的手术时间长于开腹组[(275.5±47.4)min对比(247.9±41.7)min],但术中出血量[(230.2±166.9)ml对比(448.1±268.2)ml]、输血量[(475.0±221.7)ml对比(714.3±290.5)ml]、术后盆腔引流量[(169.2±168.1)ml对比(522.3±626.7)ml]、术后肛门排气时间[(2.3±0.7)d对比(2.7±0.8)d]均明显少于开腹组,差异有统计学意义(P<0.05)。结论:腹腔镜行根治性子宫切除或改良根治性子宫切除加盆腔淋巴清除术治疗早期子宫恶性肿瘤是安全可行的,与开腹手术相比较,具有术中出血少,术后恢复快等优点。Objective： Discuss the pelvic lymphadeneetomy in patients with security, efficacy and advantage of laparoscopy in radical hysterectomy and malignant uterine tumors in early stage. The retrospecitive stud y is involving 127 patients with malignant uterine tumors operated by radical hysterectomy and pelvic lymphadenee tomy According to the surgical manner, the patients are divided to two groups： （1）Fortynine patients were treated by laparoscopy （laparoscopy group）; （2）seventyeight patients were treated by laparotomy （laparotomy group）. Multiple clinical parameters, including operative duration, blood loss, blood transfusion volume and ratio, the number of removed lymph nodes, pelvic drainage, gastrointestinal function recovery, return to normal temperature, period of using antibiotics, catheter removal time, hospitalization expenditure, WBC count, postoperative compli cations and recrudescence in the near future were the patients in laparotomy group, the patients in 47.4） min vs （247. 9 ±41.7 ） min] , less blood comparatively observed and analyzed. Results： Compared with laparoscopy group had a longer operative duration [ （230.2 ±166.9） ml vs （448. 1±268.2） ml], less blood transfusion [ （475.0±221.7） ml vs （714. 3 ±290. 5） ml], less pelvic drainage [ （ 169.2 ± 168. 1 ） ml vs （522. 3 ±626. 7 ） ml ] and shorter internal of postoperative gastrointestinal function recovery [ （2. 3 ± 0. 7 ） d vs （2. 7 ± 0. 8） d]. Conclusion： Laparoscopy in radical hysterectomy and pelvic lymphadeneetomy is safe for pa tients with malignant uterine tumors in early stage. Compared with laparoectomy, laparoscopy has the advantages of minimal invasion and fast recovery.

关 键 词：腹腔镜 子宫恶性肿瘤 根治性子宫切除术 

分 类 号：R737.33[医药卫生—肿瘤]