腹腔镜下宫颈癌根治术的近期疗效及患者预后的影响因素分析  

Short-term efficacy and influencing factors of prognosis in laparoscopic radical hysterectomy for cervical cancer patients

作　　者：孙琴花 易蓉[1] 杨丹[1] 

机构地区：[1]三峡大学中医临床医学院/宜昌市中医医院妇科,湖北宜昌443003

出　　处：《癌症进展》2016年第5期497-499,共3页Oncology Progress

摘　　要：目的：分析腹腔镜宫颈癌根治术的近期疗效及患者预后的影响因素。方法回顾性分析128例行腹腔镜宫颈癌根治术患者的病历资料，评价手术效果，术后生存情况并分析生存影响因素。结果128例患者均成功完成腹腔镜宫颈癌根治术，淋巴结的清除量是（22.34±2.42）枚，术中出血量为（203.24±23.56）ml，需术中输血的患者为6.25%（8/128），术后体温恢复至正常时间为（3.04±0.45）d，术后肛门排气时间为（2.13±0.24）d，术后平均住院时间为（12.23±2.42）d，术后尿管留置时间为（14.21±0.42）d。围手术期并发症的发生率为4.69%（6/128），术后并发症的发生率为40.63%（52/128）。术后2年的病死率为6.25%（8/128）。临床分期（OR=3.164，95%CI：1.762~5.682）、肌层浸润（OR=1352，95%CI：1.063~1.720）、盆腔淋巴结（OR=2.473，95%CI：1.034~5.915）、脉管癌栓（OR=3.245，95%CI：1.267~8.311）是影响预后的独立危险因素。分化程度（OR=0.341，95%CI：0.172~0.676）是预后的保护因素。结论宫颈癌腹腔镜根治术为安全有效的手术方式，临床分期、肌层浸润、盆腔淋巴结、分化程度、脉管癌栓是腹腔镜宫颈癌根治术后患者预后的影响因素。Objective To analyze the short-term efficacy and influencing factors of prognosis in cervical cancer pa-tients receiving laparoscopic radical hysterectomy. Method The medical records of 128 cervical cancer patients who un-derwent laparoscopic radical hysterectomy are retrospectively analyzed to evaluate the effects of the surgery, the survival rate after surgery, and the factors that influence survival. Result All the 128 patients had successfully completed laparo-scopic radical hysterectomy, and the number of resected lymph nodes was （22.34 ± 2.42）, intraoperative blood loss was （203.24 ± 23.56） ml, 6.25%（8/128） of patients had intraoperative blood transfusion, the time for postoperative body tem-perature recovery was （3.04±0.45） d, the anal exhaust time was （2.13±0.24） d, average hospital stay was （12.23±2.42） d, postoperative indwelling urinary catheter time was （14.21±0.42） d. The incidence of perioperative and postoperative com-plications was 4.69%（6/128） and 40.63%（52/128）. Death rate in 2 years after surgery was 6.25%（8/128）. Clinical stage （OR=3.164, 95%CI：1.762~5.682）, myometrial infiltration （OR=1352, 95%CI：1.063~1.720）, pelvic lymph node metasta-sis （OR=2.473, 95% CI： 1.034~5.915）, and vascular tumor thrombus （OR=3.245, 95% CI： 1.267~8.311） were indepen-dent risk prognostic factors. Differentiation （OR=0.341, 95%CI：0.172~0.676） was a protective factor affecting the prog-nosis of patients with cervical cancer. Conclusion Laparoscopic radical hysterectomy is safe and effective in treating cer-vical cancer, and the clinical stage, myometrial infiltration, pelvic lymph node metastasis, differentiation degrees, vascu-lar tumor embolus are significant factors concerning the postoperative prognosis of patients with laparoscopic radical hys-terectomy for cervical cancer .

关 键 词：腹腔镜 宫颈癌 疗效 预后 相关因素分析 

分 类 号：R737.33[医药卫生—肿瘤]