早期子宫颈癌患者腹腔镜下保留生育功能手术的疗效及妊娠结局分析  

Observation on the curative effect and pregnancy outcome of early cervical cancer patients undergoing fertility function retention surgery via laparoscopy

作　　者：陈悦 肖苏[1] 潘伟[1] Chen Yue;Xiao Su;Pan Wei.(Obstetrics and Gynecology Department, Huangshi Central Hospital（Affiliated Hospital of Hubei Polytechnic University） , Huangshi 435000, Chin)

机构地区：[1]鄂东医疗集团黄石市中心医院湖北理工学院附属医院妇产科,435000

出　　处：《中国综合临床》2018年第3期205-208,共4页Clinical Medicine of China

基　　金：黄石市卫生和计划生育委员会项目{黄科技发农[2015]3号}

摘　　要：目的研究早期子宫颈癌患者腹腔镜下保留生育功能手术的疗效及妊娠结局情况。方法选择2011年1月至2015年1月在我院治疗的67例早期子宫颈癌患者作为本次研究对象，其中研究组27例患者行保留生育功能手术，即阴道子宫颈冷刀锥切（CKC）和腹腔镜盆腔淋巴结切除术（PLD）或腹腔镜子宫颈广泛切除术（RT），对照组40例患者行腹腔镜子宫广泛性切除术（RH）；比较两组患者的围手术期情况、术中切除情况及术后复发情况，并分析研究组患者的术后妊娠情况。结果研究组27例患者中有2例因术中病检结果不符合保留生育条件而改行RH，其余25例均顺利完成CKC＋PLD或RT；研究组的术中出血量、术后排气时间及住院时间均优于对照组，差异均有统计学意义[术中出血量：（85.6±25.5） ml与（102.5±31.2） ml，t＝2.429，P＝0.018;术后排气时间：（1.4±0.3）d与（1.7±0.5）d，t＝3.065，P＝0.003;住院时间：（10.2±2.4）d与（12.3±3.5），t＝2.913，P＝0.005）]，两组患者的手术时间及尿储留、术后感染发生率的差异均无统计学意义（P均〉0.05）；两组患者的盆腔淋巴结切除个数、主韧带、宫骶韧带及阴道切除长度间的差异均无统计学意义（P均〉0.05）；随访24个月，两组患者的术后复发率[4.0%（1/25）与5.0%（2/40）]差异无统计学意义（P〉0.05），研究组25例成功保留生育功能的患者中有20例具有妊娠愿望，妊娠成功6例（6/20），其中足月分娩2例，早产2例，流产2例。结论腹腔镜下保留生育功能手术治疗早期子宫颈癌具有不错的疗效和可靠的安全性，但患者最终的妊娠结果不理想，有待改善。ObjectiveTo analyze the outcome of oncology and pregnancy on patients with early-stage cervical cancer after undergoing fertility function retention surgery via laparoscopy.MethodsSixty-seven patients with early cervical cancer treated in Huangshi Central Hospital from January 2011 to January 2015 were selected as the research subject; 27 patients in the research group were given fertility-sparing operation, also known as transvaginal cervical cold knife conization（CKC） and laparoscopic pelvic lymphadenectomy （PLD） or total laparoscopic uterine cervix extensive resection（RT））, and the patients in the control group（40 cases）were given laparoscopic uterine extensive resection（RH）; the perioperative condition, intraoperative condition and postoperative recurrence of two groups were compared, and the postoperative pregnancy status of the patients in the research group were analyzed.ResultsAmong the 27 patients in the research group, 2 patients whose intraoperative pathological examination results did not meet the standards for the fertility-sparing operation were finally treated with RH, and the other 25 patients were successfully given CKC＋ PLD or RT; In the research group, the intraoperative blood loss, postoperative exhaust time and hospital stay were better than those in the control group, and the differences were statistically significant （intraoperative blood loss： （85.6 ＋ 25.5） ml, （102.5±31.2） ml, t=2.429, P=0.018; postoperative exhaust time： （1.4±0.3） d, （1.7±0.5） d, t=3.065, P=0.003; hospital stay ： （10.2±2.4） d and （12.3±3.5）, t=2.913, P=0.005）, there was no statistically significant difference between the two groups in the operation time, incidence of urinary retention and postoperative infection （P〉0.05）; the differences between the two groups in the number of removed pelvic lymph nodes, length of cardinal ligament, length of uterosacral ligament, length of removed vaginal were not statistically significant（P〉0.05）; after 24 mon

关 键 词：子宫颈癌 保留生育功能 腹腔镜 疗效 妊娠结局 

分 类 号：R737.33[医药卫生—肿瘤]