宫颈癌腹腔镜手术疗效及影响预后的相关因素分析  

Analysis on the curative effect of laparoscopic surgery for cervical cancer and related influencing factors of prognosis

作　　者：叶惠荣[1] 范良生[1] 邓志校[1] 黄晓军[1] 杜培[1] 张晓薇[1] 

机构地区：[1]广州医科大学附属第一医院妇产科,广东广州510120

出　　处：《中国妇幼保健》2015年第21期3710-3713,共4页Maternal and Child Health Care of China

基　　金：国家自然科学基金资助项目〔81302249〕

摘　　要：目的探讨宫颈癌腹腔镜手术治疗的安全性、有效性和宫颈癌腹腔镜手术预后的影响因素。方法查阅65例宫颈癌经腹腔镜手术治疗患者的病历资料并对患者进行随访，收集手术相关信息，随访术后生存情况，进行回顾性分析。结果65例宫颈癌患者，随访时间为13～65个月，中位随访时间为44个月。术中出血量（202．15±145．10）ml，切除淋巴结数量（22．57±11．00）枚，术后肛门排气时间（2．08±0．57）天，术后拔除尿管中位时间15天，术后住院时间（12．92±4．75）天。围手术期并发症发生率4．6％，术后并发症发生率为12．5％，膀胱排尿功能障碍发生率28．1％。术后1年总体累计生存率100％，2年累计生存率93．7％，3年累计生存率91．4％。无淋巴结转移的患者2年生存率为96．5％（55／57），有淋巴结转移的患者2年生存率为71．4％（5／7），淋巴结转移对宫颈癌的预后存在显著影响（P=0．037）。结论对于宫颈癌患者腹腔镜下广泛全子宫切除＋盆腔淋巴结切除术是一种有效、安全的手术方式，单因素分析显示淋巴结转移是影响宫颈癌腹腔镜术后患者预后的相关因素。Objective To explore the safety and effectiveness of laparoscopic surgery for cervical cancer and influencing factors of prognosis. Methods The data of 65 cervical cancer patients treated by laparoscopic surgery were analyzed, the patients were followed up, the related information of surgery was collected, the postoperative survival rate was followed up, a retrospective analysis was performed. Results The follow-up time ranged from 13 to 65 months, the median was 44 months. The amount of intraoperative blood loss was （202. 15±145.10） ml, （22. 57±11.00） lymph nodes were removed, the postoperative recovery time of＇bowel function was （2.08±0. 57） days, the median of catheterization time was 15 days, the postoperative hospitalization time was （ 12. 92±4. 75 ） days. The incidence rates of perioperative and postoperative complications were 4. 6% and 12. 5%, respectively, the incidence rate of bladder dysfunction was 28. 1%. The one-year, two-year, and three-year cumulative survival rates after operation were 100. 0%, 93.7%, and 91.4%, respectively. Two- year survival rate of patients without and with lymph node metastasis were 96. 5% （55/57） and 71.4% （5/7）, respectively; lymph node metastasis had significant impact on prognosis of cervical cancer （P = 0. 037） . Conclusion For patients with cervical cancer, laparoscopic radical hysterectomy combined with pelvic lymphadenectomy is an effective and safe surgery, univariate analysis shows that lymph node metastasis is a related influencinz factor of proznosis of patients after laparoscopic surgery.

关 键 词：宫颈癌 腹腔镜手术 生存率 相关因素 

分 类 号：R711.74[医药卫生—妇产科学]