腹腔镜联合腹主动脉旁淋巴结清扫治疗子宫内膜癌的临床研究  

Clinical Study of Laparoscopy Combined with Para-aortic Lymph Node Dissection in the Treatment of Endometrial Cancer

作　　者：李丽华 李文艳 LI Lihua;LI Wenyan(Zhoukou Maternal and Child Health Care Hospital(Zhoukou Children's Hospital),Zhoukou,466000)

机构地区：[1]河南省周口市妇幼保健院,周口市儿童医院,466000

出　　处：《实用癌症杂志》2023年第1期49-51,共3页The Practical Journal of Cancer

摘　　要：目的 分析腹腔镜联合腹主动脉旁淋巴结清扫术(PAND)对子宫内膜癌(EC)患者血清肿瘤标志物及生存质量的影响。方法 选择88例EC患者,按随机数字表法将其分为开腹组(44例)、腹腔镜组(44例)。腹腔镜组采用腹腔镜联合PAND治疗,开腹组采用开腹手术治疗,观察至术后7 d。比较两组围术期指标、血清肿瘤标志物、生存质量及并发症。结果 腹腔镜组术中出血量[(56.93±10.37)ml]少于开腹组,手术时间[(65.73±8.16)min]长于开腹组,淋巴结清扫数目[(15.45±3.59)枚]多于开腹组,术后腹腔镜组癌抗原125(CA125)[(35.68±6.20)U/ml]、癌抗原199(CA199)[(36.49±6.73)U/ml]、癌胚抗原(CEA)[(15.34±3.76)ng/ml]水平低于开腹组,健康调查简表(SF-36)评分[(81.19±7.43)分]高于开腹组,腹腔镜组并发症总发生率(6.82%)低于开腹组,有统计学差异(P<0.05)。结论 腹腔镜联合PAND治疗EC淋巴结清扫更为彻底,有利于降低CA125、CA199、CEA水平,提高患者生存质量,且并发症少,临床应用安全、有效。Objective To analyze the effect of laparoscopy combined with para-aortic lymph node dissection(PAND) on serum tumor markers and quality of life in patients with endometrial cancer(EC).Methods 88 EC patients were selected and divided into laparotomy group(44 cases) and laparoscopy group(44 cases) by random number table method.The laparoscopy group was treated with laparoscopy combined with PAND,and the laparotomy group was treated with open surgery, which was observed until 7 days after surgery.Perioperative indexes, serum tumor markers, quality of life and complications were compared between the 2 groups.Results The amount of intraoperative blood loss in laparoscopy group [(56.93±10.37) ml] was less than that in the laparotomy group, the operation time [(65.73±8.16) min] was longer than that in the laparotomy group, and the number of lymph node dissection [(15.45±3.59) pieces] was higher than that in the laparotomy group.After surgery, cancer antigen 125(CA125) [(35.68±6.20) U/ml],cancer antigen 199(CA199) [(36.49±6.73) U/ml] and carcinoembryonic antigen(CEA) [(15.34±3.76) ng/ml] in the laparoscopy group were lower than those in the laparotomy group, the health survey summary(SF-36) score [(81.19±7.43) score] was higher than that in the laparotomy group, and the total incidence of complications in the laparoscopy group(6.82%) was lower than that of the laparotomy group, with statistical difference(P<0.05).Conclusion Laparoscopy combined with PAND is more thorough in EC lymph node dissection, which is beneficial to reduce the levels of CA125,CA199 and CEA and improve the quality of life of patients, with fewer complications, and safe and effective clinical application.

关 键 词：子宫内膜癌 腹腔镜 腹主动脉旁淋巴结清扫术 开腹手术 血清肿瘤标志物 生存质量 

分 类 号：R737.33[医药卫生—肿瘤]