妇科恶性肿瘤术后淋巴囊肿发生及合并感染的相关因素及疗效分析  

Related Factors for Postoperative Lymphocysts Complicated with Infection in Gynecologic Malignant Tumor Patients and Curative Effects

作　　者：张冬萍 牛星燕 余婷 彭芸花 ZHANG Dong-ping;NIU Xing-yan;YU Ting;PENG Yun-hua(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,china;The Second Clinical College of Hainan Medical University,Haikou 570311,China)

机构地区：[1]兰州大学第一临床医学院,730000 [2]海南医学院第二临床学院

出　　处：《国际妇产科学杂志》2020年第2期155-159,共5页Journal of International Obstetrics and Gynecology

基　　金：甘肃省科技计划项目(18JR3RA358)。

摘　　要：目的:探讨妇科恶性肿瘤术后淋巴囊肿发生及合并感染的相关因素及疗效分析。方法:回顾性纳入兰州大学第一医院妇产科自2017年1月2019年1月因妇科恶性肿瘤行腹腔镜手术治疗后的351例患者,根据有无淋巴囊肿的发生分为淋巴囊肿组和无淋巴囊肿组,对2组患者的一般情况、术中情况、术后实验室检查及临床病理情况进行比较。结果:单因素分析显示,妇科恶性肿瘤术后淋巴囊肿组与无淋巴囊肿组的切除淋巴结数目(P=0.000)、引流管留置时间(P=0.013)、术后放疗(P=0.005)、患者体质量指数(BMI,P=0.000)以及三酰甘油水平(P=0.004)比较,差异有统计学意义;Logistic回归分析显示术中切除淋巴结数目和患者的BMI是淋巴囊肿形成的独立影响因素(P<0.05)。淋巴囊肿合并感染者20例,发生率为17.85%;单因素分析显示感染与囊肿直径(P=0.000)、糖尿病(P=0.000)密切相关;Logistic回归分析显示囊肿直径是淋巴囊肿合并感染的独立影响因素(OR=4.375,P=0.041)。结论:妇科恶性肿瘤盆腔淋巴结切除术后发生淋巴囊肿的相关因素有切除淋巴结数目、引流管留置时间、术后辅助放疗、患者BMI及三酰甘油,囊肿直径是淋巴囊肿合并感染的独立危险因素,穿刺引流联合抗生素可作为其推荐治疗方式。Objective:To explore the related factors and curative effects for postoperative lymphocysts complicated with infection in gynecologic malignant tumor patients.Methods:A total of 351 patients with gynecologic malignant tumor who were treated by undergoing laparoscopic surgery in the First Hospital of Lanzhou University from Jan 2017 to Jan 2019 were retrosoectively enrolled in the study.According to the presence of lymphocyst formation,they were devided into lymphocyst group and no lymphocyst group.The two groups were compared in general condition,intraoperative status,postoperative laboratory tests and postoperatuve pathology.Results:The univariate analysis suggested that the incidence of lymphocyst was statistically significant with the number of dissection of lymph nodes(P=0.000),indwelling time of drainage tube(P=0.013),postoperative radiotherapy(P=0.005),body mass index(BMI,P=0.000)and triglyceride(TG,P=0.004)between the groups with and without lymph cyst.Logistic regression correlation analysis results showed that the number of resected lymphnodes and BMI were independent risk factors for lymphcyst formation(P<0.05).20 patients were complicated with lymphocyst infection during the adjuvant therapy with the incidence of 17.85%.The univariate analysis indicated that the infection was closely associated with the diameter of lymphocyst(P=0.000)and diabetes mellitus(P=0.000).The Logistic regression analysis showed that the diameter of lymphocyst was the independent influencing factor for the lymphocyst complicated with infection(OR=4.375,P=0.041).Conclusions:The number of lymph nodes resected,indwelling time of drainage tube,postoperative adjuvant radiotherapy,the patient′s BMI and TG were the related factors of lymphocysts after pelvic lymph node dissection for gynecological malignant tumor.The diameter of lymphocyst was the independent influencing factors for the lymphocyst complicated with infection.Puncture and drainage combined with antibiotics were recommended therapy.

关 键 词：妇科恶性肿瘤 生殖器肿瘤 女(雌)性 淋巴结切除术 淋巴囊肿 感染 治疗 

分 类 号：R737.3[医药卫生—肿瘤]