腹腔镜手术与开腹手术治疗宫颈癌患者的效果比较  

Comparison of the effect of laparoscopic surgery and open surgery in the treatment of cervical cancer patients

作　　者：陈吉佳 吴玉梅[1] 何玥[1] 孙雪松[1] CHEN Jijia;WU Yumei;HE Yue;SUN Xuesong(Department of Gynecological Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University Beijing Maternal and Child Health Care Hospital,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院,北京妇幼保健院妇科肿瘤科,北京100006

出　　处：《中国医药导报》2022年第8期100-103,112,共5页China Medical Herald

基　　金：北京市医院管理中心临床医学发展专项经费资助项目(ZYLX201705);北京市科学技术委员会首都临床特色应用研究项目(Z191100006619035)。

摘　　要：目的研究不同手术方式治疗宫颈癌患者,对术中、术后自主行为能力的影响。方法选取首都医科大学附属北京妇产医院妇科肿瘤科2018年1月至2021年2月接受广泛性子宫切除术的宫颈癌患者共180例,根据患者意愿分为两组,对照组接受开腹手术(138例),观察组接受腹腔镜手术(42例)。对两组术中指标、术后自主行为能力恢复情况、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分及并发症发生情况进行比较。结果观察组术中出血量及术中脏器粘连发生率低于对照组,差异有统计学意义(P<0.05)。两组住院时间、术后首次排便时间、术后首次下床活动时间及术后引流时间比较,差异无统计学意义(P>0.05)。观察组术后首次排便时间短于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDS、SAS评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜手术治疗宫颈癌的整体效果优于开腹手术,可以改善患者焦虑和抑郁情况,降低并发症的发生率。Objective To study the effect of different surgical methods on the intraoperative and postoperative autonomous behavior of patients with cervical cancer.Methods A total of 180 patients with cervical cancer who underwent extensive hysterectomy in the Department of Gynecological Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2018 to February 2021 were selected.The patients were divided into two groups according to their wishes,the control group received open surgery(138 cases),and the observation group received laparoscopic surgery(42 cases).The intraoperative indexes,postoperative autonomous behavior recovery,self-rating depression scale(SDS)and self-rating anxiety scale(SAS)scores,and complications were compared between the two groups.Results The intraoperative blood loss and the incidence of intraoperative organ adhesion in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the length of hospital stay,the time of first defecation after surgery,the time of first getting out of bed after surgery,and the time of drainage after surgery between the two groups(P>0.05).The first defecation time in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the SDS and SAS scores of the two groups were lower than those before treatment,while the observation group was lower than the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The overall effect of laparoscopic surgery for cervical cancer is better than that of open surgery,which can improve patients’anxiety and depression and reduce the incidence of complications.

关 键 词：宫颈癌 腹腔镜广泛性子宫切除术 开腹广泛性子宫切除术 自主行为能力 

分 类 号：R737.33[医药卫生—肿瘤]