中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
21期
52-55
,共4页
宫颈癌根治术%淋巴结转移%淋巴结切除术
宮頸癌根治術%淋巴結轉移%淋巴結切除術
궁경암근치술%림파결전이%림파결절제술
Cervical cancer%Lymph node metastasis%Lymphadenectomy
目的 探讨Ⅰ B2、Ⅱ A2期宫颈癌根治术中联合腹主动脉旁淋巴结切除术的临床价值.方法 2010年1月至2013年3月共收治106例Ⅰ B2、Ⅱ A2期宫颈癌患者,其中仅行宫颈癌根治术55例患者为对照组,行宫颈癌根治术同时联合腹主动脉旁淋巴结切除术51例患者为观察组;两组术后均辅以放化疗.比较两组手术情况、复发率,并分析临床病理因素与盆腔、腹主动脉旁淋巴结转移的相关性.结果 观察组复发率为15.7％(8/51),明显低于对照组的38.2％(21/55),差异有统计学意义(P＜0.05);而两组并发症发生率[27.5％ (14/51)比30.9％ (17/55)]、术中出血量[(326.1±59.1)ml比(316.1±51.2) ml]及盆腔淋巴结阳性率[56.9％(29/51)比58.2％ (32/55)]比较差异均无统计学意义(P＞0.05).观察组中腹主动脉旁淋巴结阳性率为17.6％(9/51),盆腔淋巴结转移个数与腹主动脉旁淋巴结转移呈正相关(P＜0.01).结论 在宫颈癌根治术中联合腹主动脉旁淋巴结切除术同时术后辅以放化疗,可降低其复发率,且不增加并发症,同时宫颈癌腹主动脉旁淋巴结转移数与盆腔淋巴结转移有关.
目的 探討Ⅰ B2、Ⅱ A2期宮頸癌根治術中聯閤腹主動脈徬淋巴結切除術的臨床價值.方法 2010年1月至2013年3月共收治106例Ⅰ B2、Ⅱ A2期宮頸癌患者,其中僅行宮頸癌根治術55例患者為對照組,行宮頸癌根治術同時聯閤腹主動脈徬淋巴結切除術51例患者為觀察組;兩組術後均輔以放化療.比較兩組手術情況、複髮率,併分析臨床病理因素與盆腔、腹主動脈徬淋巴結轉移的相關性.結果 觀察組複髮率為15.7％(8/51),明顯低于對照組的38.2％(21/55),差異有統計學意義(P＜0.05);而兩組併髮癥髮生率[27.5％ (14/51)比30.9％ (17/55)]、術中齣血量[(326.1±59.1)ml比(316.1±51.2) ml]及盆腔淋巴結暘性率[56.9％(29/51)比58.2％ (32/55)]比較差異均無統計學意義(P＞0.05).觀察組中腹主動脈徬淋巴結暘性率為17.6％(9/51),盆腔淋巴結轉移箇數與腹主動脈徬淋巴結轉移呈正相關(P＜0.01).結論 在宮頸癌根治術中聯閤腹主動脈徬淋巴結切除術同時術後輔以放化療,可降低其複髮率,且不增加併髮癥,同時宮頸癌腹主動脈徬淋巴結轉移數與盆腔淋巴結轉移有關.
목적 탐토Ⅰ B2、Ⅱ A2기궁경암근치술중연합복주동맥방림파결절제술적림상개치.방법 2010년1월지2013년3월공수치106례Ⅰ B2、Ⅱ A2기궁경암환자,기중부행궁경암근치술55례환자위대조조,행궁경암근치술동시연합복주동맥방림파결절제술51례환자위관찰조;량조술후균보이방화료.비교량조수술정황、복발솔,병분석림상병리인소여분강、복주동맥방림파결전이적상관성.결과 관찰조복발솔위15.7％(8/51),명현저우대조조적38.2％(21/55),차이유통계학의의(P＜0.05);이량조병발증발생솔[27.5％ (14/51)비30.9％ (17/55)]、술중출혈량[(326.1±59.1)ml비(316.1±51.2) ml]급분강림파결양성솔[56.9％(29/51)비58.2％ (32/55)]비교차이균무통계학의의(P＞0.05).관찰조중복주동맥방림파결양성솔위17.6％(9/51),분강림파결전이개수여복주동맥방림파결전이정정상관(P＜0.01).결론 재궁경암근치술중연합복주동맥방림파결절제술동시술후보이방화료,가강저기복발솔,차불증가병발증,동시궁경암복주동맥방림파결전이수여분강림파결전이유관.
Objective To investigate the clinical value of para-aortic lymphadenectomy in patients with cervical cancer in stage Ⅰ B2 and Ⅱ A2.Methods One hundred and six patients with cervical cancer in stage Ⅰ B2 and Ⅱ A2 were assigned into two groups:control group(55 patients,radical hysterectomy and pelvic lymphadenectomy) and study group (51 patients,radical hysterectomy,pelvic lymphadenectomy and para-aortic lymphadenectomy).Postoperative radiotherapy or chemotherapy was conducted appropriately.Intraoperative and postoperative characteristics,recurrence rate,survival rate were compared between two groups.Results In study group,the recurrence rate was 15.7 ％ (8/51),and in control group,the recurrence rate was 38.2％(21/55),there was significant difference (P ＜ 0.05).No significant difference were observed in the complication incidence [27.5％ (14/51) vs.30.9％ (17/55)],blood loss [(326.1 ± 59.1) ml vs.(316.1 ± 51.2) ml] and pelvic lymph node-positive rate [56.9％ (29/51) vs.58.2 ％ (32/55)](P ＞ 0.05).The incidence of para-aortic lymph node metastasis was 17.6 ％ (9/51).Positive correlation was observed between the number of the pelvic lymph node metastasis and para-aortic lymph node metastasis (P ＜ 0.01).Conclusions In cervical cancer,the number of the pelvic lymph node metastasis was associated with para-aortic lymph node metastasis,abdominal aortic lymphadenectomy in radical surgery for cervical cancer is safe and feasible and can improve the prognosis of the patients.
