摘要
目的比较腹腔镜与开腹手术行子宫根治术加盆腔淋巴结清除术的临床效果。方法回顾性分析 2003年8月至2005年8月于我院经腹腔镜行子宫根治术加盆腔淋巴结清除术的20例子宫恶性肿瘤患者(腹腔镜组)的临床资料,随机抽取2002年5月至2005年8月行同类开腹手术22例患者(开腹组)作为对照。结果腹腔镜组的手术时间为(270±84)min,明显长于开腹组的(212±65)min;术中出血量[(456±218)mL]、输血量 [(42±19)mL]、术后体温恢复正常时间[(5．2±1．3)d]、术后排气时间[(35±16)h]、住院时间[(8±2)d]均明显少于开腹组[(629±314)mL、(148±35)mL、(6．9±2．3)d、(64±28)h、(14±5)d];切除盆腔淋巴结的数目为(21±6)枚,明显多于开腹组的(17±5)枚(P值分别<0．05或<0．01)。两组间术后3 d自细胞计数、盆腔引流液量、导尿管拔除时间、住院费用的差异均无显著性(P>0．05)。结论腹腔镜下子宫根治术加盆腔淋巴结清除术可达到同类开腹手术的彻底性,并具有创伤小、恢复快等优点。
Objective To compare the clinical efficacy of laparoscopy with laparotomy in radical hysterectomy plus pelvic lymphadenectomy in patients with malignant uterine tumors. Methods This retrospective analysis included two groups： ① Twenty patients underwent laparoscopy-assisted radical hysterectomy plus pelvic lymph-adenectomy （laparoscopy group）; ② Twenty-two patients were treated with radical hysterectomy plus pelvic lymphadenectomy by laparotomy （laparotomy group）. The tumor stage in these two groups of patients was matched. Multiple clinical parameters were observed and analyzed statistically. Results Comparing with the patients in laparotomy group, the patients in laparoscopy group had a longer operative duration （270 vs 212 min）, more pelvic lymph nodes removed （21 vs 17）, less blood loss （456 vs 629 mL） and less transfusion （42 vs 148 mL）, shorter internal of postoperative gastrointestinal function recovery （35 vs 64 h）, quicker return to normal temperature （3 vs 5 d）, shorter period of using antibiotics（5 vs 7 d） and hospital stay （8 vs 14 d） （P〈0.01）. However, there were no significant differences in the followings： pelvic drainage （311 vs 214 mL）, catheter removal time （13 vs 14 d）, WBC count （10×10^9/L vs 9×10^9/L） and hospitalization expenditure （21 698 vs 19 570 yuan） between the two groups （P〉0.05）. Conclusions The efficacy of radical hysterectomy plus pelvic lymphadenectomy by laparoscopy in patients with malignant uterine tumor is similar to that of laparotomy.
出处
《上海医学》
CAS
CSCD
北大核心
2006年第5期296-299,共4页
Shanghai Medical Journal
