腹腔在子宫恶性肿瘤根治术中的临床分析  

作　　者：唐莉[1] 韦励[1] 叶建明[1] 

机构地区：[1]广东省东莞市人民医院妇产科,广东523000

出　　处：《当代医学》2014年第10期21-22,共2页Contemporary Medicine

摘　　要：目的评价腹腔镜在子宫恶性肿瘤手术治疗中的可行性及实用价值。探讨腹腔镜治疗子宫恶性肿瘤的手术技巧和并发症的防治。方法选择子宫恶性肿瘤患者,分别行腹腔镜手术(腹腔镜组,n=60)和开腹手术(开腹组,n=60),并广泛子宫切除加盆腔淋巴结清扫手术。观察2组患者手术时间、术中出血量、切除盆腔淋巴结数量、术后肛门排气时间、术后抗生素使用时间、术后住院时间和并发症等情况。结果 (236.1±97.3)ml,少于开腹组(533.5±107.7)ml;切除盆腔淋巴结数量(22.5±2.1)个,多于开腹组(18.7±3.6)个;术后肛门排气时间分别为(46.2±8.1)h,早于开腹组(65.6±7.6)h;术后抗生素使用时间(5.4±0.7)d,少于开腹组(7.1±0.4)d;住院天数分别为(8.3±1.6)d,短于开腹组(10.9±2)d;2组比较差异均有统计学意义(P<0.05)。但腹腔镜组平均手术时间为(263.2±43.3)min长于开腹组(203.1±27.5)min(P<0.05)。腹腔镜术后并发症发生率为18.3%,开腹组为20%,2组差异均无统计学意义。结论腹腔镜广泛子宫切除加盆腔淋巴结清扫手术治疗子宫恶性肿瘤安全、可行,有临床应用价值。Objective To compare the feasibility and the clinical efficacy on laparoscopic and laparotomic surgery in treating uterine malignancies, and to investigate the surgical techniques of laparoscopic for uterine malignancies and prevention treatment of complications.Method 60 patients with uterine malignancies who were treated with laparoscopic surgery（laparoscopy group,60 cases） and laparotomic surgery （laparotomy group,60 cases） extensive hysterectomy and pelvic lymph node dissection. The patients of two groups were observed with operation time, blood loss, number of pelvic lymph node resection, and exhaust time, the use of antibiotics in time, postoperative hospital stay and complications, etc.Results Laparoscopy group, blood loss （236.1±97.3）ml was less than laparotomy group （533.5±107.7）ml; pelvic lymph node excision （22.5±2.1） was more than laparotomy group （18.7±3.6）; anal discharge （46.2±8.1）h was earlier than that in the laparotomy group （65.6±7.6）h; the use of antibiotics in time （5.4±0.7）d was less than laparotomy group （7.1±0.4）d; postoperative hospital stay （8.3±1.6）d was shorter than the laparotomy group （10.9±2）d. There were signiifcant differences （allP〈0.05）. But in the laparoscopy group, the operative time （263.2±43.3）min was longer than laparotomy group （203.1±27.5）min （P〈0.05）. The occurrence rate of other complications had no statistically signiifcant differences between the laparoscopy group 18.3% and the laparotomy group 20%.Conclusion Laparoscopic extensive hysterectomy and pelvic lymphdenectomy for uterine malignancies is safe, feasible and of clinical application value.

关 键 词：子宫恶性肿瘤 广泛性全子宫切除 淋巴结清扫术 腹腔镜手术 

分 类 号：R737.33[医药卫生—肿瘤]