【摘要】 目的探讨子宫颈癌患者手术并发症的发生原因及其防治策略。方法回顾性分析2003年1月至2008年4月间311例接受子宫颈癌根治术患者的资料,其中ⅠA2期10例,占3.21%;ⅠB1期88例,占28.29%;ⅠB2期42例,占13.50%;ⅡA期(局部病灶≤4cm)127例,占40.84%;ⅡA期(局部病灶>4cm)44例,占14.14%。术后病理类型:鳞癌262例,占84.24%;腺癌37例,占11.90%;腺鳞癌7例,占2.30%;小细胞癌4例,占1.30%。下腹部手术史有96例,占30.87%。本组中,有71例术前接受化疗。结果全组121名患者出现手术并发症,发生率为38.91%;术中并发症有泌尿系损伤、血管损伤;术后并发症以尿潴留、淋巴囊肿、腹部伤口感染为主,发生率分别为13.50%、10.61%和7.07%。在发生术后尿潴留的患者中,术前化疗者29例,占40.85%(29/71),与未接受过新辅助化疗13例(5.42%,13/240)相比较,差异有统计学意义(P=0.011)。结论子宫颈癌根治术后并发症有一定的发生率,与手术范围较大有关;新辅助化疗有可能增加手术并发症。更多还原

【Abstract】 Objective To investigate the causes of complications in cervical cancer patients receiving radical hysterectomy plus pelvic lymphadenectomy,and to develop preventive measures.Methods Between Jan 2003 and Apr 2008,clinical data from 311 patients with cervical cancer in this hospital underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively analyzed.According to the International Federation of Gynecology and Obstetrics(FIGO) staging system,the percentage of patients with stage IA2,stage IB1,stage IB2,stage IIA(≤4 cm) and stage ⅡA(>4 cm) was 3.21%(10 cases),28.29%(88 cases),13.50%(42 cases),40.84%(127 cases) and 14.14%(44 cases),respectively.71 patients received neochemotherapy before surgery.Results 121 patients(38.91%) developed perioperative complications.During the operation,damage of the urinary system and vessel was noted,but the incidence was not high.The major postoperative complications included bladder dysfunction(13.50%),formation of lymphocysts(10.61%) and wound infection(7.07%).Hydronephrosis and formation of ureteral fistulas were not found.Patients receiving neochemotherapy were likely to suffer from bladder dysfunction and blood lost during operation.Conclusion Complications associated with radical hysterectomy and pelvic lymphadenectomy are frequently found.And the occurrence is correlated with the extent of surgical procedure.Neochemotherapy may increase the incidence of complication.更多还原