摘要
目的总结分析早期宫颈癌局部巨块型患者行阴式广泛子宫切除术并发症发生情况,探讨降低并发症发生率的方法。方法收集石家庄市第一医院2011年6月至2016年6月期间收治早期宫颈癌病例(ⅠA2-ⅡA期)资料,筛选出行阴式广泛子宫切除术+腹腔镜盆腔淋巴结清扫术者共258例,分为观察组(局部巨块组)和对照组(常规组),比较两组手术相关并发症发生情况,以及先期化疗对局部巨块型患者并发症的影响情况。结果观察组(ⅠB2/ⅡA2期)93例发生并发症26例(27.9%),高于对照组(ⅠA2/ⅠBl/ⅡA1期)165例中的28例(17.0%),差异有统计学意义(P<0.05);观察组膀胱损伤发生率高于对照组(5例vs 2例),差异有统计学意义(P<0.05),其余并发症发生率差异无统计学意义(P>0.05)。对于局部巨块型早期宫颈癌患者,先期化疗组并发症发生率为6例(15.8%),低于单纯手术组的20例(36.4%),差异有统计学意义(P<0.05);先期化疗组输尿管损伤发生率低于单纯手术组(0例vs 6例),差异有统计学意义(P<0.05),两组其余并发症发生率差异无统计学意义(P>0.05)。结论局部巨块型(ⅠB2/ⅡA2期)早期宫颈癌患者行阴式广泛子宫切除术并发症发生率较高,先期化疗能够缩小病灶体积,减少病灶充血,降低手术并发症发生率。
Objective To analyze the complications of radical vaginal hysterectomy in patients with locally bulky cervical cancer. Methods All 258 patients of early cervical cancer （ stage [ A2- ⅡA） se- lected in our hospital during the period of June 2011 to June 2016 undergoing radical vaginal hysterectomy and laparoscopic pelvic lymph node dissection were analyzed. All cases were divided into observation （lo- cally bulky） and control （conventional） groups. Comparison analysis was performed for complications of the two groups and the influence of neoadjuvant chemotherapy on the complications of local bulky patients. Re- stilts The incidence of complications in the observation group was 26 cases （27.9%） , higher than that in the control group of 28 cases （ 17.0% ）, the difference was statistically significant （ P 〈 0. 05 ）. The inci- dence of bladder injury （5 cases vs 2 cases） in observation group was significantly higher than that in con- trol group （ P 〈 0. 05 ）. For patients with locally bulky early cervical cancer, the incidence rate of complica- tions of the neoadjuvant chemotherapy group （ 15.8% ） was significantly lower than the simple operation group （36. 4% ） （P 〈0. 05）. The incidence rate of ureteral injury in neoadjuvant chemotherapy group （0 cases vs 6 cases） was significantly lower than that in simple operation group （ P 〈 0. 05 ）. Conclusions Early cervical cancer patients with locally bulky （ stage I B2/]I A2） had higher incidence of complications of radical vaginal hysterectomy, and neoadjuvant chemotherapy can reduce the incidence of surgical compli- cations.
出处
《中国医师杂志》
CAS
2018年第1期83-86,共4页
Journal of Chinese Physician
基金
石家庄市科学技术研究与发展指导计划(171461423)~~
