可吸收防粘连纤维膜对卵巢癌患者术后盆腔淋巴囊肿形成的影响  

Effect of absorbable anti-adhesion fibrous membrane on the incidence of lymphoceles in patients with ovarian cancer

作　　者：王元芬 窦莎 朱崇元 朱秀红[2] 崔恒[1] 李艺[1] Wang Yuanfen;Dou Sha;Zhu Chongyuan(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044)

机构地区：[1]北京大学人民医院妇产科,北京100044 [2]山东省青岛市即墨人民医院妇科,青岛266299

出　　处：《现代妇产科进展》2022年第12期906-910,共5页Progress in Obstetrics and Gynecology

基　　金：北京市自然科学基金资助项目(No:7222204)。

摘　　要：目的:评估在卵巢癌患者盆腔淋巴结清扫区域使用可吸收防粘连纤维膜能否降低淋巴结切除术后淋巴囊肿的发生率。方法:回顾分析2018年10月至2020年12月于北京大学人民医院及山东省青岛市即墨人民医院初次手术治疗的109例卵巢癌患者的资料,术中使用可吸收防粘连纤维膜的卵巢癌患者85例(干预组),未进行防粘连处理的卵巢癌患者24例(对照组)。患者均进行全面分期手术或肿瘤细胞减灭术,同时行盆腔淋巴结及腹主动脉旁淋巴结切除术。术后通过临床症状、影像学检查(B超、CT扫描或MRI)诊断淋巴囊肿。比较两组患者的淋巴囊肿发生率,伴有症状的淋巴囊肿发生率,以及淋巴囊肿直径。结果:术后发生淋巴囊肿54例(49.54%),伴有症状(压痛、感染、下肢水肿)的淋巴囊肿4例(3.67%)。干预组中36例(42.35%)患者术后出现淋巴囊肿,对照组18例(75.00%)患者术后出现淋巴囊肿(P=0.005)。干预组中1例患者(1.18%)发生淋巴囊肿感染,对照组有3例(12.5%)为伴有症状的淋巴囊肿(P=0.033)。干预组和对照组的淋巴囊肿直径比较,差异无统计学意义[(6.02±2.90)cm vs(6.54±3.05)cm,P=0.551],干预组中出现直径>5cm淋巴囊肿发生率显著低于对照组(25.88%vs 58.33%,P=0.003)。结论:卵巢癌术后淋巴囊肿形成仍是术后较常见的并发症。可吸收防粘连纤维膜可有效减少卵巢癌术后淋巴囊肿形成及症状性淋巴囊肿的发生。Objective:To evaluate whether the application of anti-adhesive patches in the area of lymph node dissection in patients with ovarian cancer can reduce the incidence of lymphocele after lymphadenectomy.Methods:The data of patients diagnosed with ovarian cancer in Peking University People’s Hospital and Jimo People’s Hospital from October 2018 to December 2020 were analyzed retrospectively.There were 85 patients who used intraoperative anti-adhesion patch in the intervention group and 24 patients without anti-adhesion treatment in the control group.All patients underwent staging surgery or tumor cytoreduction surgery,as well as pelvic lymph node and para-aortic lymph node dissection.The incidence of lymphocele and symptomatic lymphocele,and the diameter of lymphocele were compared between the two groups.Results:54(49.54%)lymphoceles and 4(3.67%)symptomatic lymphoceles were observed.Lymphoceles were observed in 36(42.35%)patients in the intervention group,and 18(75%)patients in the control group(P=0.005).Symptomatic lymphoceles were observed in 1(1.18%)patient in the intervention group,and 3(12.5%)patients in the control group(P=0.033).There was no significant difference in the diameter of lymphocele between the two groups[(6.02±2.90)cm vs(6.54±3.05)cm,P=0.551].The incidence of the diameter of lymphocele>5 cm was significantly lower in the intervention group than in the control group(25.88%vs 58.33%,P=0.003).Conclusion:Lymphocele formation after ovarian cancer is still one of common postoperative complications.The application of anti-adhesion paths can effectively reduce the incidence of lymphoceles and symptomatic lymphoceles,which could improve patients’quality of life,further shorten hospitalization time,and provide postoperative adjuvant therapy on time.

关 键 词：卵巢癌 淋巴囊肿 淋巴结切除术 可吸收防粘连纤维膜 

分 类 号：R737.31[医药卫生—肿瘤]