宫颈癌根治术合适手术范围及疗效的研究  

Study of the Proper Extent of the Radical Hysterectomy of Cervical Carcinoma and Its Therapeutic Result

作　　者：吴义勋[1] 任品金[2] 董长江[3] 史惠蓉[3] 张智强[3] 张红玲 韩升高[4] 

机构地区：[1]河南医科大学第一附院妇产科 [2]河南医科大学三附院妇产科 [3]第一附院妇产科河南医科大学 [4]河南医科大学流行病学教研室

出　　处：《河南肿瘤学杂志》1992年第2期23-27,共5页Henan Journal of Oncology

摘　　要：我院1973～1985年作宫颈癌根治术441例,其中84例术时进行切除范围的测量。Ⅰ_b期42例,Ⅱ_a期36例,Ⅱ_b期6例。切除主韧带8～14cm^2,宫骶韧带12～19cm^2,阴道旁2.5～5.9cm^2,阴道2～3.5cm。5年、10年存活率较多切除者高,即切除范围扩大存活率未见增加而略有降低。但经统计学检验差异无显著性(P均>0.05)。提示上述切除范围对Ⅰ_b期、Ⅱ_a期是合适的。本组随访率100.0％。5年存活率94.05％,其中Ⅰ_b期95.24％,Ⅱ_a期94.44％,Ⅱ_b期5/6。术后尿潴留占11.91％(10/84),输尿管阴道瘘占2.38％(2/84)。本文对手术合适的切除范围、降低术后并发症、提高对淋巴结转移的疗效及Ⅱ~b期手术问题进行了讨论。From 1973 to 1985,441 patients with cervical carcinoma underwent radical hysterectomy treatment in our department. Among them the incision extent of 84 patients was measured during oper ation,42 cases being stage Ⅰ_ b,36 cases stage Ⅱ_a,and 6 cases stage Ⅱ_b. The excision extent of cardinal ligaments was 8～14cm^2, utero-sacral ligaments 12～19cm^2, paravaginal 2.5～5.9cm^2 and the vaginal 2～3.5cm. The five-year and ten-year survival rates of these patients were higher than those of the patients with large incision extent,that is to say,enlarging the operation extent not only increased the survival rate, but also decreased it slightly. However,it was no statistical significance(P>0.05) as compared with the small incision extent. After operation, 100% of the patients were followed up. The five-year survival rate was 94.05%. Among them stage Ⅰ_b, Ⅱ_a, Ⅱ_b, being respectively 95.24%,94.44% and 5/6. The incidence of urine ratention after operation was 11.91%(10/54), ureteral fistula 2.38%. In this paper,the proper operation extent,the reduced postoperation complication, the surgical factors increasing the curative effect on the patients with lymph nodes metastasis,and the problem of the operation on the patients of stage Ⅱ_b are discussed.

关 键 词：子宫颈肿瘤 手术 疗效 

分 类 号：R737.330.5[医药卫生—肿瘤]