【摘要】 目的 分析宫颈原位癌患者应用腹腔镜辅助下阴式子宫全切除术治疗的效果。方法 选取64例宫颈原位癌患者,采取随机数字表法将所有患者分为观察组和对照组,每组32例。观察组应用腹腔镜辅助下阴式子宫全切除术治疗,对照组应用开腹手术治疗。比较两组患者手术指标(术中出血量、手术时间、淋巴结清扫数目)、术后恢复指标(引流管拔除时间、首次排气时间、首次排便时间、住院时间)、并发症(尿潴留、切口感染、尿瘘、输尿管损伤、淋巴囊肿)发生情况。结果 与对照组的(378.48±28.02)ml、(207.26±34.42)min相比,观察组患者术中出血量(156.50±27.69)ml更少,但手术时间(244.40±43.43)min更长(P<0.05)；两组淋巴结清扫数目比较无明显差异(P>0.05)。与对照组的(3.22±0.73)、(3.66±0.82)、(4.98±0.82)、(11.09±1.24)d相比,观察组患者首次排气时间(2.32±0.34)d、首次排便时间(2.55±0.64)d、引流管拔除时间(3.04±0.67)d、住院时间(9.20±1.02)d更短(P<0.05)。与对照组的31.25%相比,观察组并发症发生率9.38%更低(P<0.05)。结论 应用腹腔镜辅助下阴式子宫全切除术治疗宫颈原位癌能够取得与开腹手术相当的效果,且术中出血量更少,术后恢复更快,并发症更少,但手术时间有所延长,总体上看具有显著优势。更多还原

【Abstract】 Objective To analyze the effect of laparoscopic-assisted vaginal hysterectomy for cervical carcinoma in situ. Methods 64 patients with cervical carcinoma in situ were selected and divided into observation group and control group using a random number table, with 32 cases in each group. The observation group was treated with laparoscopic-assisted vaginal hysterectomy, while the control group was treated with open surgery. Patients in both groups were compared in terms of surgical indexes(intraoperative blood loss, operation time, number of lymph node dissection), postoperative recovery indexes(drainage tube removal time, first exhaust time, first defecation time, hospitalization time) and complications(urinary retention, incision infection, urinary fistula, ureteral injury, lymphocysts). Results Compared with(378.48±28.02) ml and(207.26±34.42) min in the control group, the observation group had less intraoperative blood loss(156.50±27.69) ml, but longer operation time(244.40±43.43) min(P<0.05). There was no significant difference in the number of lymph node dissection between the two groups(P>0.05). Compared with(3.22±0.73),(3.66±0.82),(4.98±0.82) and(11.09±1.24) d in the control group, the observation group had shorter first exhaust time(2.32±0.34) d, first defecation time(2.55±0.64) d, drainage tube removal time(3.04±0.67) d and hospitalization time(9.20±1.02) d(P<0.05). The complication rate of 9.38% in the observation group was lower than 31.25% in the control group(P<0.05). Conclusion The application of laparoscopic-assisted vaginal hysterectomy for the treatment of cervical carcinoma in situ can achieve the equal effect as open surgery, with less blood loss, faster postoperative recovery,and fewer complications, but the operation time is prolonged, and has significant advantages in general.更多还原