摘要
目的探讨腹腔镜下全子宫加双附件切除术对子宫内膜癌患者术后急性疼痛的影响。方法选取2017年1月至2021年3月间化州市人民医院收治的114例早期子宫内膜癌患者作为研究对象,采用随机数表法分为研究组与对照组,每组57例。对照组给予腹腔镜下广泛性全子宫切除术,研究组给予腹腔镜下全子宫加双附件切除术,比较两组患者术后不同时间点的急性疼痛状况。结果两组的手术时间、术中出血量对比,差异无统计学意义(P>0.05),研究组的术后住院时间、术后留置导尿管时间和术后肛门排气时间均少于对照组,差异均有统计学意义(均P<0.05)。研究组术后14d的静脉血栓、低蛋白血症、尿潴留和泌尿系感染等并发症发生率为3.5%,低于对照组的21.1%,差异有统计学意义(P<0.05)。研究组术后1d、术后3d、术后7d与术后14d的疼痛评分均低于对照组,差异均有统计学意义(均P<0.05)。两组术后14d的血清脂联素含量低于术前1d,研究组低于对照组,差异均有统计学意义(均P<0.05)。研究组术后14d的健康状况和功能状况评分均高于对照组,而症状领域、躯体领域评分均低于对照组,差异均有统计学意义(均P<0.05)。结论腹腔镜下全子宫加双附件切除术在子宫内膜癌患者中应用,有利于缓解术后急性疼痛,抑制血清脂联素的释放,能促进患者康复,减少术后并发症的发生,从而提高患者的生活质量。
Objective To investigate the effect of total laparoscopic hysterectomy plus removal of double uterine appendage on acute postoperative pain in patients with endometrial cancer.Methods From January 2017 to March 2021,114 patients with early endometrial cancer who were diagnosed and treated at Huazhou People’s Hospital were selected.They were divided into an experimental group and a control group with 57 patients in each group using random number table method.The experimental group underwent total laparoscopic hysterectomy plus removal of double uterine appendages and the control group underwent total laparoscopic hysterectomy.Acute postoperative pain were compared between the two groups at different time points after the operation.Results There were no significant difference in the duration of operation and intraoperative blood loss between the two groups(P>0.05).The length of postoperative hospital stay,length of postoperative indwelling catheter stay,and time to postoperative anal exhaust were less of the experimental group than in the control group(all P<0.05).The incidence of complications including venous thrombosis,hypoproteinemia,urinary retention,and urinary tract infection was 3.5%in the experimental group at 14 d after operation,which was lower than 21.1%of the control group(P<0.05).The pain visual analogue scale(VAS)scores at 1,3,7 and 14 d after the operation were lower in the experimental group in the control group(all P<0.05).The levels of serum adiponectin(APN)at 14 d after the operation were lower than those at 1 d before the operation in the two groups,and those were lower in the experimental group than in the control group(all P<0.05).The scores of health and functional status were higher in the experimental group than in the control group at 14 d after the operation(all P<0.05).The scores of the symptom and physical fields were lower in the experimental group than in the control group(all P<0.05).Conclusion Total laparoscopic hysterectomy plus the removal of double uterine appendages is beneficial to relieve acute postoperative pain,inhibit the release of serum APN,promote patient recovery,reduce postoperative complications and improve quality of life in patients with endometrial cancer.
作者
梁园
陈彩红
吴华平
LIANG Yuan;CHEN Cai-hong;WU Hua-ping(Department of Gynecology,Huazhou People's Hospital,Huazhou 525100,China)
出处
《中国肿瘤临床与康复》
2022年第5期558-562,共5页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
腹腔镜
全子宫加双附件切除术
子宫内膜肿瘤
脂联素
并发症
生活质量
Laparoscopy
Total hysterectomy plus the removal of double uterine appendages
Endometrial neoplasms
Adiponectin
Complications
Quality of life
