腹腔镜下行子宫切除术及淋巴清扫术治疗老年子宫颈癌的疗效

目的:探讨腹腔镜与开腹下行子宫切除术及淋巴清扫术治疗老年子宫颈癌患者的临床疗效。方法:选取2014年1月至2016年1月我院收治的60例老年子宫颈癌患者,随机分为两组,每组30例,A组患者接受开放性子宫切除术及淋巴清扫术,B组患者在腹腔镜下行子宫切除术及淋巴清扫术,比较两组患者的手术情况、术后恢复情况以及术中、术后并发症的发生情况和随访期间的生活质量。结果:B组患者手术中淋巴结的清扫数目明显比A组多(P0.05),术中出血量和术后使用镇痛泵的次数明显少于A组(P0.05),抗生素的使用时间、术后排气时间、膀胱功能恢复时间、引流管滞留时间、住院时间较A组患者明显缩短(P0.05),术中大出血以及术后尿潴留、淋巴囊肿的发生率显著低于A组(P0.05);术后3个月和6个月的I-QOL以及FACT-G评分显著高于A组(P0.05)。结论:腹腔镜下行子宫切除术加盆腔淋巴清扫术治疗老年子宫颈癌患者的临床疗效显著,有利于患者术后恢复,并有效提高患者术后生活质量。

The Clinical Effect of Hysterectomy and Lymph Node Dissection under Laparoscope on Elderly Patients with Cervical Cancer

ABSTRACT Objective: To investigate the curative effect of hysterectomy and lymph node dissection with laparoscope or laparotomy on elderly patients with cervical cancer. Methods: 60 elderly patients with cervical cancer were enrolled in our hospital from January 2014 to January 2016 and randomly divided into two groups. Group A (n=30) accepted hysterectomy and lymph node dissection with laparotomy, and Group B (n=30) adopted same surgery with laparoscope, the operation condition and postoperative recovery were compared between two groups. The intraoperative and postoperative complications of all patients were recorded and analyzed, and the quality of life of patients was evaluated in the following-up period. Results: The number of lymph node dissection in Group B was significantly more than that of Group A(P<0.05); the intraoperitive blood loss and the times of using postoperative analgesia pump in Group B were significantly fewer than those in Group A (P<0.05). The time of postoperative exhaust, bladder function recovery, drainage tube retention and hospital stay in Group B were all shorter than those in Group A(P<0.05). The incidence of massive hemorrhage during operation and postoperative urinary retention and lymphatic cyst in Group B were significantly lower than those patients in Group A (P<0.05). After operation 3 and 6 month, the I-QOL and FACT-G scores of patients in Group B were significantly higher than those in Group A (P<0.05). Conclusion: Hysterectomy and lymph node dissection under laparoscope had remarkable curative effect on the elderly patients with cervical cancer, which improved the postoperative recovery and the quality of life of patients.