摘要
目的:探讨妇科恶性肿瘤患者行腹腔镜下淋巴结清扫术后淋巴漏的发生、危险因素、临床表现及诊断治疗方法。方法:回顾分析2009年9月至2012年8月在复旦大学附属妇产科医院行腹腔镜下腹膜后淋巴结清扫术的849例妇科恶性肿瘤患者的临床资料,分析患者术后淋巴漏发生的相关因素。结果:46例(5.42%)患者术后发生淋巴漏,其中42例为淡黄色引流液,4例为乳糜样引流液,引流量为300～1150ml/d。Logistic多元回归分析显示,淋巴结清扫数、淋巴结转移、术中出血量与淋巴漏发生有关。46例患者经限制饮食或禁食、静脉营养及引流等保守治疗后,均治愈。结论:淋巴漏的临床症状依据发生位置不同而表现各异。淋巴结转移、淋巴结清扫数及术中出血量是淋巴漏发生的危险因素。保守治疗及充分引流可获得满意效果;术中轻柔操作、提高手术技巧及术后预防性禁食可预防淋巴漏发生。
Objective：To evaluate the incidence,diagnosis,risk factors and treatment of lymphorrhagia after laparoscopic lymphadenectomy in gynecologic malignancies.Methods：To retrospectively reviewed the cases of 849 patients who underwent laparoscopic lymphadenectomy for gynecologic malignancies from Sep.2009 to Aug.2012 in Gynecologic and Obstetric Hospital,Fudan University.Result：46（5.42%） patients had lymphorrhagia postoperatively.46 patients represented persistent massive drainage ranging from 300ml to 1150ml per day.Including 42 cases with clear yellow fluid and 4 cases with chylous ascites.The operative blood loss,numbers of lymph node dissection and metastasis were associated with postoperative lymphorrhagia.All cases with lymphorrhagia were resolved by conservative treatment.Conclusions：Operative blood loss,numbers of lymph node dissection and metastasis may be risk factors of lymphorrhagia.Most of these patients recovered with conservative treatment.To reducing the occurrence of lymphorrhagia,careful surgical techniques should be recommended and absolute fast should be valuable for high risk patients.
出处
《现代妇产科进展》
CSCD
2013年第6期449-452,共4页
Progress in Obstetrics and Gynecology
关键词
淋巴漏
腹腔镜下淋巴结清扫
妇科恶性肿瘤
治疗
Lymphorrhagia
Laparoscopic lymphadenectomy
Gynecologic malignan- cies
Therapy
