【摘要】 目的探讨系统性淋巴结清扫术对子宫内膜癌患者预后的影响。方法以80例子宫内膜癌患者为研究对象,将其随机分为观察组(40例)与对照组(40例)。对照组患者进行次广泛全子宫+双附件切除+盆腔淋巴结清扫术,观察组患者在次广泛全子宫+双附件切除基础上同时进行系统性盆腔、腹主动脉旁淋巴结清扫术。对2组患者术后并发症发生率及术后2年复发转移率与生存率进行观察与比较。结果在术后并发症发生率上,观察组为35. 0%,对照组为30. 0%,2组差异无统计学意义(P> 0. 05)。术后对患者进行2年的回访,观察组2年复发转移率为12. 5%,对照组2年复发转移率为37. 5%,观察组明显低于对照组(P <0. 05);在2年生存率上,观察组为92. 5%,对照组为70. 0%,观察组明显高于对照组(P <0. 05)。结论在子宫内膜癌治疗中,行系统性淋巴结清扫术虽然并发症发生率有所增加,但与常规手术相比差异并不显著,却能够显著降低患者近期复发转移率并大大提升患者近期生存率,预后良好,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the effect of systematic lymphadenectomy on the prognosis of patients with endometrial carcinoma. Methods 80 patients with endometrial cancer were randomly divided into the observation group( 40 cases) and the control group( 40 cases). Patients in the control group received subtotal hysterectomy + double adnexal resection + pelvic lymphadenectomy,while patients in the observation group received systemic pelvic and paraaortic lymphadenectomy on the basis of subtotal hysterectomy + double adnexal resection. The incidence of postoperative complications,recurrence and metastasis rates and survival rates in 2 years after operation were observed and compared between the 2 groups. Results The incidence of postoperative complications was 35. 0% in the observation group and 30. 0% in the control group. There was no significant difference between the two groups( P > 0. 05). Patients were followed up for 2 years after operation. the recurrence and metastasis rate in the observation group was 12. 5% in 2 years and 37. 5% in the control group. the recurrence and metastasis rate in the observation group was significantly lower than that of the control group( P < 0. 05). In terms of 2-year survival rate,the observation group was 92. 5%,the control group was 70. 0%,the observation group was significantly higher than the control group( P < 0. 05). Conclusion In the treatment of endometrial cancer,although the incidence of complications has increased,systematic lymphadenectomy is not significantly different from conventional surgery,but it can significantly reduce the recent recurrence and metastasis rate of patients and greatly improve the short-term survival rate of patients,with good prognosis,and is worthy of clinical application.更多还原