CAJ | 학술논문

目的：评价腹腔镜在子宫恶性肿瘤手术治疗中的可行性及实用价值。探讨腹腔镜治疗子宫恶性肿瘤的手术技巧和并发症的防治。方法选择子宫恶性肿瘤患者，分别行腹腔镜手术（腹腔镜组，n=60）和开腹手术（开腹组，n=60），并广泛子宫切除加盆腔淋巴结清扫手术。观察2组患者手术时间、术中出血量、切除盆腔淋巴结数量、术后肛门排气时间、术后抗生素使用时间、术后住院时间和并发症等情况。结果(236.1±97.3)ml，少于开腹组(533.5±107.7)ml；切除盆腔淋巴结数量(22.5±2.1)个，多于开腹组(18.7±3.6)个；术后肛门排气时间分别为(46.2±8.1)h，早于开腹组(65.6±7.6)h；术后抗生素使用时间（5.4±0.7）d，少于开腹组（7.1±0.4）d；住院天数分别为(8.3±1.6)d，短于开腹组(10.9±2)d；2组比较差异均有统计学意义(P<0.05)。但腹腔镜组平均手术时间为(263.2±43.3)min长于开腹组(203.1±27.5)min(P<0.05)。腹腔镜术后并发症发生率为18.3%，开腹组为20%，2组差异均无统计学意义。结论腹腔镜广泛子宫切除加盆腔淋巴结清扫手术治疗子宫恶性肿瘤安全、可行，有临床应用价值。
목적：평개복강경재자궁악성종류수술치료중적가행성급실용개치。탐토복강경치료자궁악성종류적수술기교화병발증적방치。방법선택자궁악성종류환자，분별행복강경수술（복강경조，n=60）화개복수술（개복조，n=60），병엄범자궁절제가분강림파결청소수술。관찰2조환자수술시간、술중출혈량、절제분강림파결수량、술후항문배기시간、술후항생소사용시간、술후주원시간화병발증등정황。결과(236.1±97.3)ml，소우개복조(533.5±107.7)ml；절제분강림파결수량(22.5±2.1)개，다우개복조(18.7±3.6)개；술후항문배기시간분별위(46.2±8.1)h，조우개복조(65.6±7.6)h；술후항생소사용시간（5.4±0.7）d，소우개복조（7.1±0.4）d；주원천수분별위(8.3±1.6)d，단우개복조(10.9±2)d；2조비교차이균유통계학의의(P<0.05)。단복강경조평균수술시간위(263.2±43.3)min장우개복조(203.1±27.5)min(P<0.05)。복강경술후병발증발생솔위18.3%，개복조위20%，2조차이균무통계학의의。결론복강경엄범자궁절제가분강림파결청소수술치료자궁악성종류안전、가행，유림상응용개치。
Objective To compare the feasibility and the clinical efficacy on laparoscopic and laparotomic surgery in treating uterine malignancies, and to investigate the surgical techniques of laparoscopic for uterine malignancies and prevention treatment of complications.Method 60 patients with uterine malignancies who were treated with laparoscopic surgery(laparoscopy group,60 cases) and laparotomic surgery (laparotomy group,60 cases) extensive hysterectomy and pelvic lymph node dissection. The patients of two groups were observed with operation time, blood loss, number of pelvic lymph node resection, and exhaust time, the use of antibiotics in time, postoperative hospital stay and complications, etc.Results Laparoscopy group, blood loss (236.1±97.3)ml was less than laparotomy group (533.5±107.7)ml; pelvic lymph node excision (22.5±2.1) was more than laparotomy group (18.7±3.6); anal discharge (46.2±8.1)h was earlier than that in the laparotomy group (65.6±7.6)h; the use of antibiotics in time (5.4±0.7)d was less than laparotomy group (7.1±0.4)d; postoperative hospital stay (8.3±1.6)d was shorter than the laparotomy group (10.9±2)d. There were signiifcant differences (allP<0.05). But in the laparoscopy group, the operative time (263.2±43.3)min was longer than laparotomy group (203.1±27.5)min (P<0.05). The occurrence rate of other complications had no statistically signiifcant differences between the laparoscopy group 18.3% and the laparotomy group 20%.Conclusion Laparoscopic extensive hysterectomy and pelvic lymphdenectomy for uterine malignancies is safe, feasible and of clinical application value.