摘要
目的探讨腹腔镜与开腹手术治疗子宫内膜癌的临床疗效。方法按照手术方式不同,将140例子宫内膜癌患者分为腹腔镜手术治疗(腹腔镜组)和传统开腹手术治疗(开腹手术组),每组70例。比较2组术中出血量、清扫淋巴结个数、手术时间、盆腹腔引流量、肛门排气时间、术后镇痛药使用、下床活动时间、术后导尿管留置时间、术后住院时间、术后并发症发生率,随访期间2组患者复发、转移情况以及手术前后2组患者血清肿瘤标志物HE4、CA125水平和免疫功能指标IgG、CD_4/CD_8水平。结果 2组术中清扫淋巴结个数差异无统计学意义(P>0.05);腹腔镜组术中出血量、手术时间、盆腹腔引流量、首次肛门排气时间、术后镇痛药使用、下床活动时间、术后导尿管留置时间、术后住院时间均优于开腹组,差异有统计学意义(P<0.05)。腹腔镜组并发症发生率为10.00%,显著低于开腹组的25.71%(P<0.05)。随访期间,2组远端转移与局部复发比较差异无统计学意义(P>0.05)。此外,术后2组血清HE4、CA125水平均明显降低(P<0.05),并且腹腔镜组降低水平较开腹组更明显(P<0.05)。术后2组IgG、CD_4/CD_8水平均较术前明显降低,但开腹组中CD_4/CD_8水平降低差异无统计学意义(P<0.05);腹腔镜组IgG、CD_4/CD_8水平改善优于开腹组(P<0.05)。结论腹腔镜手术治疗EC可取得与开腹手术治疗相同的疗效,并具有创伤小、术中出血量少、恢复快、住院时间短,并发症发生率低等优势,值得推广。
Objective To investigate the clinical curative effects of laparoscopic surgery and laparotomy in treatment of endometrial cancer(EC).Methods According to different surgical methods,140 patients with EC were divided into laparoscopic surgery group(laparoscopic group)and traditional laparotomy surgery group(laparotomy group),with 70 patients in each group.The intraoperative bleeding volume,the numbers of cleanin lymph nodes,operation time,drainage volume of pelvic cavity and abdominal cavity,the time of anal exhaust,use of analgesics after operation,the time of getting out of bed,indwelling time of catheter after operation,the postoperative hospitalization duration,the incidence rate of postoperative complications,the recurrence and metastasis during follow-up,the serum levels of tumor markers-HE4,CA125 and immunological function indexes including IgG and CD4/CD8 before and after operation were observed and compared between two groups.Results There were no significant differences in the numbers of cleaning lympho nodes between two groups(P>0.05).The intraoperative bleeding volume,operation time,drainage volume of pelvic cavity and abdominal cavity,the time of anal exhaust,use of analgesics after operation,the time of getting out of bed,indwelling time of catheter after operation and hospitalization time in laparoscopic group were superior to those in laparotomy group(P<0.05).The incidence rate of complications in laparoscopic group was 10.00%,which was significantly lower than that(25.715)in laparotomy group(P<0.05).There were no significant differences in distal metastasis and local recurrence between two groups(P>0.05).Besides,the serum levels of HE4 and CA125 were significantly decreased after operation in both groups(P<0.05),moreover the decrease degree in laparoscopic group was more obvious than that in laparotomy group(P<0.05).Moreover the levels of IgG and CD4/CD8 were significantly decreased in both groups,as compared with those before operation,moreover,the decrease degree in laparoscopic group was more ob
作者
刘剑煌
吕育纯
李苹
许丽洪
LIU Jianhuang;LV Yuchun;LI Ping(Department of Gynaecology and Obstetrics,The First Hospital of Quanzhou City,Fujian,Quanzhou 362002,China)
出处
《河北医药》
CAS
2018年第7期974-977,共4页
Hebei Medical Journal
关键词
腹腔镜
开腹手术
子宫内膜癌
临床对比
laparoscope
laparotomy
endometrial cancer
clinical contrast
