腹腔镜下宫颈癌根治术后严重并发症的预测因素分析  

Predictors of Severe Complications after Radical Hysterectomy for Cervical Cancer

作　　者：吴科 王冬[2] 唐郢[3] WU Ke;WANG Dong;TANG Ying(Affiliated Tumor Hospital of Chongqing University,Chongqing,400030)

机构地区：[1]重庆大学附属肿瘤医院,400030 [2]重庆市肿瘤研究所,400030 [3]重庆市肿瘤医院,400030

出　　处：《实用癌症杂志》2020年第5期770-773,785,共5页The Practical Journal of Cancer

基　　金：重庆市科委社会发展领域科技项目(编号:cstc2016shmszx130062)。

摘　　要：目的研究腹腔镜下宫颈癌根治性子宫切除联合盆腔淋巴结清扫术患者发生严重并发症情况,探讨与严重并发症发生有关的因素。方法选取确诊为宫颈癌并行腹腔镜根治性子宫切除联合盆腔淋巴结清扫术的患者为研究对象,其中发生严重并发症的患者共45例为并发症组,并选择同期、同年龄段未发生严重并发症的患者104例为对照组,分析2组患者的临床资料、血液学指标及手术等情况。结果2组患者体重、肿瘤病理分型、肿瘤分期、补体C3、SCC、CA125、淋巴结清扫数量、阴道切除长度、主韧带切除长度间差异无统计学意义(P>0.05),并发症组BMI、肿瘤直径、住院时长、C反应蛋白水平显著高于对照组(t=4.193,P=0.000,t=2.070,P=0.040,t=2.135,P=0.034,t=2.380,P=0.019);血红蛋白、白蛋白水平显著低于对照组(t=2.771,P=0.006,t=2.260,P=0.025);并发症组手术时间及术中出血量显著高于对照组(t=2.313,P=0.022,t=3.009,P=0.003)。将相关因素进行Logistic回归分析,结果显示BMI水平(OR=1.156,P=0.007)、C反应蛋白水平(OR=1.069,P=0.026)、术中出血量(OR=1.008,P=0.001)均为严重并发症发生的危险因素,血红蛋白水平(OR=0.965,P=0.049)为保护因素。结论行腹腔镜根治性子宫切除联合盆腔淋巴结清扫术的宫颈癌患者中,BMI、血红蛋白水平、C反应蛋白水平、术中出血量与严重并发症的发生存在显著的相关性,监测上述指标可预测术后严重并发症的发生。Objective To analyze the incidence of severe complications in patients undergoing radical hysterectomy for cervical cancer,and to explore the related factors and correlation with the occurrence of serious complications.Methods 45 cases with diagnosis of cervical cancer patients with radical hysterectomy parallel were selected as the complications group,at the same time,there was no serious complications of patients 104 cases as the control group,analysis the clinical data of the 2 groups of patients,hematology indexes and operation.Results There was no significant difference between the 2 groups of patients'body weight,tumor pathological type,tumor stage,C3,SCC,CA125,the number of lymph node dissection,length of vaginal and ligament removal(P>0.05),complications group's BMI,the tumor diameter,the length of hospital time,CRP level was significantly higher than the control group(t=4.193,P=0.000,t=2.070,P=0.040,t=2.135,P=0.034,t=2.380,P=0.019).The hemoglobin and albumin levels were significantly lower than those of the control group(t=2.771,P=0.006,t=2.260,P=0.025).The operative time and intraoperative blood loss in the complications group were significantly higher than those of the control group(t=2.313,P=0.022,t=3.009,P=0.003).Logistic regression analysis showed that BMI(OR=1.156,P=0.007),CRP level(OR=1.069,P=0.026)and intraoperative blood loss(OR=1.008,P=0.001)was risk factors for severe complications,hemoglobin level(OR=0.965,P=0.049)was the protective factor.Conclusion In patients undergoing radical hysterectomy for cervical cancer,BMI,hemoglobin level,CRP level and intraoperative blood loss was significantly correlated with the occurrence of severe complications,which can be used to predict the occurrence of postoperative severe complications.

关 键 词：宫颈癌 根治性子宫切除术 并发症 BMI LOGISTIC回归分析 

分 类 号：R737.33[医药卫生—肿瘤]