悬吊式免气腹免举宫腹腔镜手术在早期宫颈癌患者中的应用效果  

Application effect of suspended pneumoperitoneum-free laparoscopic surgery without uterine manipulator in patients with early cervical cancer

作　　者：谢文阳[1] 李萍 费静 邹纯静[1] XIE Wenyang;LI Ping;FEI Jing;ZOU Chunjing(Department of Obstetrics and Gynecology,Jiujiang Maternal and Child Health Hospital,Jiujiang 332000,Jiangxi,China;Department of Obstetrics and Gynecology,the Sixth People’s Hospital of Jiujiang City,Jiujiang 332000,Jiangxi,China)

机构地区：[1]九江市妇幼保健院妇产科,江西九江332000 [2]九江市第六人民医院妇产科,江西九江332000

出　　处：《癌症进展》2023年第19期2132-2135,共4页Oncology Progress

基　　金：江西省卫生健康委科技计划项目(202311604)。

摘　　要：目的探讨悬吊式免气腹免举宫腹腔镜手术在早期宫颈癌患者中的应用效果。方法根据手术方式的不同将50例早期宫颈癌患者分为免气腹组(n=24,悬吊式免气腹免举宫腹腔镜手术)和气腹组(n=26,传统腹腔镜手术)。比较两组患者的术中指标、血流动力学指标[平均动脉压(MAP)、心率(HR)、吸气峰压(PIP)、呼气末二氧化碳分压(PetCO_(2))]、术后指标及并发症发生情况。结果两组患者术中出血量和淋巴结清扫数目比较,差异均无统计学意义(P﹥0.05);免气腹组患者手术时间明显长于气腹组,差异有统计学意义(P﹤0.01)。手术1 h,两组患者MAP均低于本组术前,PIP、PetCO_(2)均高于本组术前,免气腹组患者MAP高于气腹组,PIP、PetCO_(2)均低于气腹组,差异均有统计学意义(P﹤0.05)。免气腹组患者肛门排气时间、拔除尿管时间、术后住院时间均明显短于气腹组,差异均有统计学意义(P﹤0.01)。两组患者术后并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论悬吊式免气腹免举宫腹腔镜手术应用于早期宫颈癌患者,可促进患者术后恢复,避免CO_(2)气腹对机体的影响,缩短患者住院时间。Objective To investigate the application effect of suspended pneumoperitoneum-free laparoscopic surgery without uterine manipulator in patients with early cervical cancer.Method A total of 50 patients with early cervical cancer were divided into pneumoperitoneum-free group(n=24,suspended pneumoperitoneum-free laparoscopic surgery without uterine manipulator)and pneumoperitoneum group(n=26,traditional laparoscopic surgery)according to different surgical methods.The intraoperative indicators,hemodynamic indicators[mean arterial pressure(MAP),heart rate(HR),peak inspiratory pressure(PIP),partial pressure of end-tidal carbon dioxide(PetCO_(2))],postoperative indicators,and the occurrence of complications were compared between the two groups.Result There were no significant differences in the intraoperative blood loss and number of lymph node dissection between the two groups(P>0.05).The operation time of the pneumoperitoneum-free group was significantly longer than that of the pneumoperitoneum group,and the difference was statistically significant(P<0.01).One hour after the operation,the MAP of the two groups were lower than those before the operation,and the PIP and PetCO_(2) were higher than those before the operation,the MAP of the pneumoperitoneum-free group was higher than that of the pneumoperitoneum group,and the PIP and PetCO_(2) were lower than those of the pneumoperitoneum group,and the differences were statistically significant(P<0.05).The anal exhaust time,urinary catheter removal time,and postoperative hospitalization time in the pneumoperitoneum-free group were significantly shorter than those in the pneumoperitoneum group,and the differences were statistically significant(P<0.01).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion It is useful to perform suspended pneumoperitoneum-free laparoscopic surgery without uterine manipulator on patients with early cervical cancer,which could promote postoperative recovery,avoid the

关 键 词：早期宫颈癌 悬吊式免气腹免举宫腹腔镜手术 血流动力学指标 并发症 

分 类 号：R737.33[医药卫生—肿瘤]