单孔腹腔镜广泛子宫切除术联合盆腔淋巴结清扫术在宫颈癌患者中的应用效果  

Application effect of single port laparoscopic extensive hysterectomy combined with pelvic lymph node dissection in patients with cervical cancer

作　　者：陈晓霞[1] 曲丽霞[1] 王娜 CHEN Xiaoxia;QU Lixia;WANG Na(Department of Gynecology,Sanmenxia Central Hospital,Sanmenxia 472000,He’nan,China)

机构地区：[1]三门峡市中心医院妇科,河南三门峡472000

出　　处：《癌症进展》2021年第19期2020-2023,2043,共5页Oncology Progress

摘　　要：目的探讨单孔腹腔镜广泛子宫切除术+盆腔淋巴结清扫术在宫颈癌患者中的应用效果。方法依据手术方式将120例宫颈癌患者分为单孔组和传统组,每组60例,传统组患者给予传统腹腔镜广泛子宫切除术+盆腔淋巴结清扫术治疗,单孔组患者给予单孔腹腔镜广泛子宫切除术+盆腔淋巴结清扫术治疗。比较两组患者围手术期指标、应激指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)]、生活质量[癌症治疗功能评价系统量表共性模块(FACT-G)]和并发症发生情况。结果单孔组患者手术时间明显长于传统组(P﹤0.01),术中出血量明显低于传统组(P﹤0.01),首次通气时间、首次排便时间、首次下床活动时间和住院时间均明显短于传统组(P﹤0.01)。术后1天,两组患者血清CRP、IL-6水平均高于本组术前(P﹤0.05),且单孔组患者血清CRP、IL-6水平均低于传统组(P﹤0.05)。单孔组患者术后并发症总发生率为8.33%,与传统组患者的15.00%比较,差异无统计学意义(P﹥0.05)。术后6、12、24个月,两组患者FACT-G评分均逐渐升高(P﹤0.05)。结论与传统腹腔镜手术相比,单孔腹腔镜广泛子宫切除术+盆腔淋巴结清扫术尽管延长了手术时间,但术中出血量更少,应激反应轻微,有利于患者的术后恢复。Objective To explore the application effect of single port laparoscopic extensive hysterectomy+pelvic lymph node dissection in patients with cervical cancer.Method According to the surgical method,120 patients with cervical cancer were divided into single port group and traditional group,60 cases in each group.Patients in the traditional group were treated with traditional laparoscopic extensive hysterectomy+pelvic lymph node dissection,and patients in the single port group were treated with single-port laparoscopic extensive hysterectomy+pelvic lymph node dissection.The perioperative indicators,stress indicators[C-reactive protein(CRP),interleukin-6(IL-6)],quality of life[functional assessment of cancer therapy-general(FACT-G)]and complications of the two groups were compared.Result The operation time of patients in the single port group was significantly longer than that of the traditional group(P<0.01),and the amount of intraoperative blood loss was significantly lower than that of the traditional group(P<0.01),the first ventilation time,the first defecation time,the first time to get out of bed and the hospital stay were significantly shorter than the traditional group(P<0.01).One day after surgery,the serum CRP and IL-6 levels of the two groups of patients were higher than those of the preoperative group(P<0.05),and the serum CRP and IL-6 levels of the single-well group were lower than those of the traditional group(P<0.05).At 6,12,and 24 months after surgery,the FACT-G scores of the two groups of patients gradually increased(P<0.05).Conclusion Compared with traditional laparoscopic surgery,single port laparoscopic extensive hysterectomy+pelvic lymph node dissection may extend the operation time,but there is less blood loss during the operation and mild stress response,which is beneficial to the patient’s postoperative recovery.

关 键 词：广泛子宫切除术 盆腔淋巴结清扫术 单孔腹腔镜 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]