子宫次全切术联合双附件切除及系统性淋巴结切除术治疗子宫内膜癌患者效果观察  

Observation on the effect of subtotal hysterectomy combined with bilateral adnexectomy and systemic lymphadenectomy in the treatment of patients with endometrial cancer

作　　者：邬光祠 WU Guangci(Xingshan People's Hospital,Yichang 443799,China)

机构地区：[1]兴山县人民医院,湖北宜昌443799

出　　处：《包头医学院学报》2021年第5期54-56,96,共4页Journal of Baotou Medical College

摘　　要：目的:探讨子宫次全切术联合双附件切除及系统性淋巴结切除术治疗子宫内膜癌患者效果。方法:选取2017年2月至2020年2月在本院行手术治疗的96例子宫内膜癌患者分为观察组和对照组,观察组给予子宫次全切除+双附件切除+系统性淋巴结清扫治疗,对照组给予子宫次全切除+双附件切除+盆腔淋巴结清扫治疗,比较两组患者手术指标、性激素水平、术后1年生存率和复发率、术后并发症发生情况。结果:观察组患者手术时间、术中出血量、淋巴结清扫数量及淋巴结(+)率较对照组患者显著提高(P<0.05);术前两组患者孕、雌激素水平无显著性差异(P>0.05),术后3个月两组患者孕、雌激素水平均显著改善,且观察组患者术后3个月雌、孕激素改善更显著(P<0.05);术后1年,观察组生存率为93.75%,显著高于对照组的75.00%(P<0.05),复发率为8.33%,显著低于对照组的35.42%(P<0.05);两组患者术后下肢水肿、淋巴囊肿、深静脉血栓、输尿管瘘、不全性肠梗阻等并发症发生率无显著性差异(P>0.05)。结论:子宫次全切术联合双附件切除及系统性淋巴结切除术治疗子宫内膜癌可提高淋巴结清扫数量及淋巴结阳性检出率,减少复发,改善患者雌、孕激素水平及生存质量。Objective:To explore and analyze the effect of subtotal hysterectomy combined with bilateral adnexectomy and systemic lymphadenectomy in the treatment of endometrial cancer patients.Methods:96 patients with endometrial cancer undergoing surgical treatment in Xingshan People's Hospital from February 2017 to February 2020 were chosen and divided into the observation group and the control group.The observation group were given subtotal hysterectomy+bilateral adnexectomy+systemic lymph node dissection treatment,while the control group were given subtotal hysterectomy+bilateral adnexectomy+pelvic lymph node dissection treatment,with surgical indicators,sex hormone levels,1-year survival rates and recurrence rates after surgery and occurrence of postoperative complications compared.Results:The operation time,intraoperative blood loss and the number of lymph nodes dissected and lymph nodes(+)of the observation group were more significantly improved compared with those of the control group(P<0.05);there was no significant difference in the levels of pregnancy and estrogens between the two groups before surgery(P>0.05);and the levels of pregnancy and estrogen were significantly improved in the two groups 3 months after the operation,with the improvement in the observation group more significant(P<0.05).1 year after operation,the survival rate of the observation group was 93.75%,higher than that of the control group and the recurrence rate in the observation group was 8.33%,significantly lower than that of the control group(35.42%)(P<0.05).There was no significant difference in the incidence of postoperative complications such as lower extremity edema,lymphatic cysts,deep vein thromboses,ureteral fistulae,and incomplete intestinal obstruction between the two groups(P>0.05).Conclusion:Subtotal hysterectomy combined with bilateral adnexectomy and systemic lymphadenectomy in the treatment of endometrial cancer increases the number of lymph node dissections,the positive detection rate of lymph nodes,reduces recurrence,improves

关 键 词：系统性淋巴结切除术 盆腔淋巴结清扫 腹主动脉旁淋巴结清扫 子宫内膜癌 

分 类 号：R737.33[医药卫生—肿瘤]