CAJ | 학술논문

目的：对比分析腹腔镜下广泛子宫切除+盆腔淋巴结清扫术与传统开腹手术治疗子宫恶性肿瘤的近期效果及应用价值。方法对襄阳市中心医院2010年6月~2013年3月收治的43例早期子宫恶性肿瘤患者进行腹腔镜下广泛性全子宫切除术+盆腔淋巴结清扫术(腹腔镜组)，并和同期43例经腹行广泛性全子宫切除术+盆腔淋巴结清扫术的早期子宫恶性肿瘤患者(开腹组)进行对照，比较两种术式的手术时间、术中出血量、清扫淋巴结数目、术中及术后并发症等。结果与开腹组相比，43例腹腔镜组的患者术中失血量少[(336.28±240.49)mL比(479.07±317.02)mL，P<0.05]、清除淋巴结数目多[(18.95±3.87)个比(17.02±3.89)个，P<0.05]、术后肛门排气时间短[(1.43±0.40)d比(2.29±0.44)d，P<0.05]、术后住院天数少[(9.63±1.93)d比(11.14±3.36)d，P<0.05]以及输血比例低[(16.28%)比(41.86%)，P<0.05]，差异有统计学意义；手术时间较开腹组长，但差异无统计学意义[(231.04±64.33)min比(209.30±45.07)min，P>0.05]。结论在早期子宫恶性肿瘤的手术方式中，与传统开腹手术相比，腹腔镜组具有同样的有效性和安全性，同时减少了术中出血量及术后并发症，减少了手术创伤，缩短了住院时间，术后患者恢复快，为妇科恶性肿瘤应用微创手术治疗提供了良好的应用前景。
목적：대비분석복강경하엄범자궁절제+분강림파결청소술여전통개복수술치료자궁악성종류적근기효과급응용개치。방법대양양시중심의원2010년6월~2013년3월수치적43례조기자궁악성종류환자진행복강경하엄범성전자궁절제술+분강림파결청소술(복강경조)，병화동기43례경복행엄범성전자궁절제술+분강림파결청소술적조기자궁악성종류환자(개복조)진행대조，비교량충술식적수술시간、술중출혈량、청소림파결수목、술중급술후병발증등。결과여개복조상비，43례복강경조적환자술중실혈량소[(336.28±240.49)mL비(479.07±317.02)mL，P<0.05]、청제림파결수목다[(18.95±3.87)개비(17.02±3.89)개，P<0.05]、술후항문배기시간단[(1.43±0.40)d비(2.29±0.44)d，P<0.05]、술후주원천수소[(9.63±1.93)d비(11.14±3.36)d，P<0.05]이급수혈비례저[(16.28%)비(41.86%)，P<0.05]，차이유통계학의의；수술시간교개복조장，단차이무통계학의의[(231.04±64.33)min비(209.30±45.07)min，P>0.05]。결론재조기자궁악성종류적수술방식중，여전통개복수술상비，복강경조구유동양적유효성화안전성，동시감소료술중출혈량급술후병발증，감소료수술창상，축단료주원시간，술후환자회복쾌，위부과악성종류응용미창수술치료제공료량호적응용전경。
Objective To compare the application value and efficacy of laparoscopic radical hysterectomy and pelvic lymphadenectomy with traditional laparotomy for the treatment of uterine malignancies. Methods From June 2010 to March 2013 in Xiangyang Central Hospital, 43 cases of patients with early uterine malignancy were scheduled for la-paroscopic radical hysterectomy and pelvic lymphadenectomy (laparoscopic group) as treatment, at the same period 43 cases of patients with early uterine malignancy were recruited to be the laparotomy group who were given traditional laparotomy. The time of surgery, amount of bleeding, number of dissected pelvic lymph nodes, complication of intraop-erative and postoperative of the two groups were compared. Results Compared with the laparotomy group, 43 patients in the laparoscopic group showed less intraoperative blood loss [(336.28±240.49)mL vs (479.07±317.02) mL, P<0.05], more remove lymph node number [(18.95±3.87) vs (17.02±3.89), P < 0.05], shorter postoperative anal exhaust time [(1.43±0.40)d vs (2.29±0.44) d, P< 0.05], less postoperative hospital stay [(9.63±1.93) d vs (11.14±3.36) d, P< 0.05], lower proportion of blood transfusion [(16.28%) vs (41.86%), P<0.05], the differences were statistically significant; the longer operative time [(231.04±64.33) min vs (209.30±45.07) min, P> 0.05], but the difference was not statistically significant. Conclusion The study compares the therapeutic efficacy of laparoscopic surgery and traditional laparotomy for the early uterine malignancy, finds that the laparoscopic surgery has the same efficacy and safety, while reducing the amount of bleeding, the postoperative complications and the surgical trauma, shorting the hospital stay, fasting the postoperative recovery, thus provides a good prospect of micro invasive surgery for the gynecological malignancices.