腹腔镜治疗子宫内膜癌临床效果观察与分析

The clinical effect observation and analysis on treatment of endometrial carcinoma by laparoscopy

摘要:

目的 对腹腔镜和开腹手术治疗子宫内膜癌效果进行比较和分析，为临床提供参考依据。方法 随机选择2009年1月～2012年12月子宫内膜癌患者112例，腹腔镜手术患者63例，为观察组，经腹手术患者49例，为对照组。观察两组治疗效果、术中和术后基本情况及并发症等，并对患者进行1年随访。结果 两组治疗效果、清扫淋巴结数目和术后复发结果比较，差异均无显著性（P >0.05）。观察组的平均出血量为（248.52±27.63）mL，低于对照组（341.47±39.72）mL（P <0.05）；观察组手术时间为（176.48±4.76）min，多于对照组（148.27±6.26）min（P <0.05）；观察组术后体温恢复时间、排气时间和膀胱功能恢复时间及住院时间分别为（2.92±0.63）d、（24.52±2.04）h、（8.16±0.76）d和（11.19±0.88）d，均低于对照组（P <0.05）。观察组并发症为12.70%（8/63），低于对照组22.45%（11/49）（P <0.05）。观察组盆腔感染和深静脉血栓/肺栓塞分别为1.59%（1/63）和0.00%（0/63），均低于对照组8.16%（4/49）和4.08%（2/49）（P <0.05）。结论 两种术式均可有效治疗宫内膜癌，腹腔镜手术术后恢复更快，并发症更少，有利于患者术后恢复。

Abstract:

【Objective】 To compare and analyze the effect of laparoscopic and abdominal operation for the treatment of endometrium carcinoma and provide clinical reference . 【Methods】 110 patients with endometrial carcinoma were selected randomly in our hospital from January in 2009 to December in 2012, 63 patients with laparoscopic operation were as the observation group, and 47 patients with abdominal operation were as the control group. The therapeutic effect of two groups, basic situation during operation and postoperative and complications, and follow-up after 1 year were compared. 【Results】 Therapeutic effective cleaning number of lymph nodes, postoperative recurrence were not significant statistically between the two groups (P＞0.05). The average bleeding volume of the observation group was (248.52±27.63)mL, lower than that of the control group (341.47±39.72) mL (P<0.05); The operation time of the observation group was 176.48±4.76min,more than that of the control group (148.27±6.26) min (P<0.05); The body temperature recovery time (2.92±0.63) d, exhaust time(24.52±2.04)h, bladder function recovery time(8.16±0.76)d, hospitalization time(11.19±0.88)d in the observation group were lower than those in the control group(P<0.05). The complication of the observation group was 12.70% (8/63), lower than that of the control group 22.45% (11/49) (P<0.05). The pelvic infection and deep venous thrombosis/pulmonary embolism of the observation group were 1.59% (1/63) and 0.00% (0/63), lower than the control group 8.16% (4/49) and 4.08%(2/49) (P<0.05). 【Conclusion】 Two kinds of operation methods could be effective in treatment of endometrial cancer, while the patients with laparoscopic operation could be faster recovery, fewer postoperative complications, and help the patients postoperative recovery.