妇科盆腔淋巴结清扫术后淋巴囊肿的预防  

Prevention of lymph cyst after gynecological pelvic lymph node drainage

作　　者：姜涛[1] 张亚[1] 何雅静[1] 赵婷婷[1] 

机构地区：[1]荆州市第一人民医院妇产科,湖北荆州434000

出　　处：《热带医学杂志》2015年第5期638-641,共4页Journal of Tropical Medicine

摘　　要：目的探讨不同淋巴结断端处理方式和盆腔引流对妇科盆腔淋巴结清扫术后淋巴囊肿的影响。方法选取2011年1月至2013年12月荆州市第一人民医院收治的妇科肿瘤患者200例,随机数字表法分为4组,其中A组和B组各50例,均予以4号丝线结扎淋巴管断端,但A组患者阴道断端放置28号打孔橡胶引流管1根,B组患者阴道残端放置负压引流管1根;C组和D组各50例,采用百克钳电凝淋巴管断端,但C组患者阴道断端放置28号打孔橡胶引流管1根,D组患者阴道残端放置负压引流管1根。记录比较4组患者手术时间、术中出血量、淋巴结切除数目、引流管拔管天数、平均住院天数、淋巴囊肿发生率和淋巴囊肿平均直径。结果四组患者在手术过程中的淋巴结清除数目无明显差异(P>0.05),C组和D组手术时间和术中出血量较A组和B组手术时间和术中出血量明显降低,差异有统计学意义(P<0.05),但A组与B组比较,C组与D组比较手术时间和术中出血量均无明显差异(P>0.05);B组、C组和D组患者引流管拔管天数和平均住院天数均明显少于A组,差异有统计学意义(P<0.05);B组、C组和D组三组引流管拔管天数和平均住院天数互相比较差异有统计学意义(P<0.05);A组淋巴囊肿发生率和淋巴囊肿平均直径均明显高于B、C、D组,差异有统计学意义(P<0.05);而B组、C组、D组3组相互比较,淋巴囊肿发生率和淋巴囊肿平均直径均差异均有统计学意义(P<0.05)。结论百克钳配合负压引流是预防妇科盆腔淋巴结清扫术后淋巴囊肿发生的最佳方法,对临床具有指导意义,值得临床推广。Objective To investigate the effect of different treatments and pelvic lymph drainage on lymph cyst formation after gynecological pelvic lymph node drainage. Methods 200 patients with gynecological tumor were randomly divided into four groups. Group A and group B（n =50） were ligated lymphatic end with number 4 thread, but in group A patients, a number 28 rubber drainage tube was placed at the vaginal cuff, in group B patients, a negative pressure drainage tube was placed at the vaginal cuff.Group C and group D each 50 cases, lymphatic cut ends were sealed by hectogram pliers electric coagulation, but in group C, a number 28 rubber drainage tube was placed at the vaginal cuff,in group D, a negative pressure drainage tube was placed at the vaginal cuff. The operation time, intraoperative blood loss, number of lymph node excision, drainage tube, incidence of lymph cyst and lymph cyst average diameter were compared between groups. Results There were no significant differences in the number of lymph node removal surgery in patients among 4 groups（P 〉0.05）. The operation time and intraoperative blood loss in group C and D were significantly lower than those in group A and B（P 〈0.05）.However, compared between group A and group B, or group C and group D the operation time and intraoperative blood loss were not significantly different（P 〉0.05）. The days for withdrawing drainage tubes and the average hospitalization days in group B, C and D were significantly less than those in group A（P 〈0.05）.The days for withdrawing drainage tubes and the average hospitalization days among group B, C and D were significantly different（P 〈0.05）.The lymphocele incidence and lymph cyst average diameter in group A were significantly higher than those in group B, C, and D（P 〈0.05）. The incidence of lymph cyst and lymph cyst average diameter among group B, C and D were significantly different（P〈0.05）. Conclusion Hectogram tong electric coagulation of lymphatic end can obviously shorten the operati

关 键 词：妇科肿瘤 淋巴结清扫 淋巴囊肿 盆腔引流 

分 类 号：R713[医药卫生—妇产科学]