筋膜外子宫切除术与根治性子宫切除术对Ⅰ期子宫内膜癌的疗效比较  

Clinical Observation of Extrafascial Hysterectomy and Radical Hysterectomy in Treatment of StageⅠEndometrial Cancer

作　　者：宋俊霞 丰树菊 SONG Junxia FENG Shuju(Jiaozuo Coal Industry(Group)Co.,Ltd.Central Hospital,Jiaozuo,454000)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院,454000

出　　处：《实用癌症杂志》2025年第4期654-656,661,共4页The Practical Journal of Cancer

摘　　要：目的探讨筋膜外子宫切除术与根治性子宫切除术治疗Ⅰ期子宫内膜癌(EC)的临床效果。方法选择行手术治疗的80例Ⅰ期EC患者,按随机数字表法分为筋膜组和根治组,各40例。根治组行根治性子宫切除术,筋膜组行筋膜外子宫切除术。对比两组围术期指标、排尿功能、并发症。结果相比于根治组,筋膜组术中出血量少,术后排气时间、住院时间、手术时间短,有统计学差异(P<0.05);两组术后最大尿流率均低于术前,残余尿量多于术前,且根治组术后排尿量、最大逼尿肌压力、平均尿流率均低于术前,有统计学差异(P<0.05);相比于根治组,筋膜组术后残余尿量少,最大尿流率、最大逼尿肌压力、排尿量、平均尿流率高,有统计学差异(P<0.05);筋膜组术后排尿量、最大逼尿肌压力、平均尿流率与术前相比,无统计学差异(P>0.05);相比于根治组,筋膜组术后并发症发生率低,有统计学差异(P<0.05)。结论与根治性子宫切除术相比,使用筋膜外子宫切除术治疗Ⅰ期EC可减小手术创伤,减少并发症发生,促进排尿功能恢复,加快患者术后恢复进程。Objective To investigate the clinical effects of extrafascial hysterectomy and radical hysterectomy in the treatment of stageⅠendometrial cancer(EC).Methods 80 patients with stageⅠEC who underwent surgical treatment were divided into fascia group and radical treatment group by random number table,40 cases each.Radical hysterectomy was performed in the radical treatment group,and extrascial hysterectomy was performed in the fascia group.Perioperative indexes,urination function and complications were compared between the 2 groups.Results Compared with radical treatment group,fascia group had less intraoperative blood loss and shorter postoperative exhaust time,hospital stay and operation time,with statistical difference(P<0.05).The maximum urine flow rate after surgery was lower than before surgery,the residual urine volume was higher than before surgery,and the postoperative urine volume,maximum detrusor pressure and average urine flow rate in radical treatment group were lower than before surgery,with statistical differences(P<0.05).Compared with the radical treatment group,the postoperative residual urine volume in fascia group was lower,and the maximum urine flow rate,maximum detrusor pressure,urine output and average urine flow rate were higher,with statistical differences(P<0.05).There were no significant differences in postoperative urine output,maximum detrusor pressure and average urine flow rate in fascia group compared with those before surgery(P>0.05).Compared with radical treatment group,the incidence of postoperative complications in fascia group was lower,with statistical difference(P<0.05).Conclusion Compared with radical hysterectomy,the use of extrafascial hysterectomy in the treatment of stageⅠEC can reduce surgical trauma,reduce complications,promote the recovery of urination function,and accelerate the postoperative recovery process of patients.

关 键 词：子宫内膜癌 筋膜外子宫切除术 排尿功能 根治性子宫切除术 并发症 

分 类 号：R737.33[医药卫生—肿瘤]