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目的探讨腹腔镜与开腹行子宫广泛性切除术治疗Ⅰa2~Ⅱb期子宫颈癌的临床效果。方法选取2010年12月至2015年12月间四川省达州市渠县人民医院收治的92例Ⅰa2~Ⅱb期子宫颈癌患者,采用随机数字表法分为观察组与对照组,每组46例。观察组患者行腹腔镜子宫广泛性切除术,对照组患者行开腹子宫广泛性切除术,比较两组患者手术效果及术后并发症。结果观察组患者手术时间为(153.8±31.6)min,术中出血量为(208.3±41.2)ml,术中输液量为(1342.7±179.2)ml,术后排气时间为(1.6±0.4)d,术后发热时间为(2.0±0.8)d,下床活动时间为(1.8±0.5)d,留置尿管时间为(13.7±2.0)d,术后住院时间为(16.2±2.3)d,均少于对照组的(198.7±25.4)min、(356.1±60.7)ml、(1859.4±214.3)ml、(2.8±0.7)d、(2.7±0.9)d、(2.6±0.7)d、(16.6±1.8)d和(20.4±2.6)d,两组比较,差异均有统计学意义(均P<0.05)。观察组患者术中尿量为(337.5±69.4)ml,清除淋巴结数量为(13.2±2.6)枚,均多于对照组的(251.8±71.0)ml和(11.0±1.8)枚,观察组患者术后并发症发生率为2.2%,低于对照组的15.2%,两组比较,差异均有统计学意义(均P<0.05)。结论腹腔镜比开腹行子宫广泛性切除术疗效更佳,安全性更高。
Objective To investigate the clinical effect of laparoscopic and open radical hysterectomy for cervical cancer Ⅰa2 ~ Ⅱb. Methods 92 patients with stage Ⅰa ~ 2b cervical cancer admitted to Daxian County People’s Hospital of Dazhou, China from December 2010 to December 2015 were randomly divided into observation group and control group with 46 cases in each group. The patients in the observation group underwent laparoscopic radical uterine resection and the control group underwent open excision of abdominal uterus. The surgical effects and postoperative complications were compared between the two groups. Results The operation time of the observation group was (153.8 ± 31.6) min, the intraoperative blood loss was (208.3 ± 41.2) ml, the intraoperative infusion volume was (1342.7 ± 179.2) ml and the postoperative exhaust time was (1.6 ± 0.4) d (2.0 ± 0.8) days postoperatively, duration of bed ambulation (1.8 ± 0.5 days), indwelling catheter time (13.7 ± 2.0) days and postoperative hospital stay (16.2 ± 2.3) days, respectively Less than the control group (198.7 ± 25.4) min, (356.1 ± 60.7) ml, (1859.4 ± 214.3) ml, (2.8 ± 0.7) d, (2.7 ± 0.9) d, (2.6 ± 0.7) d 1.8) d and (20.4 ± 2.6) d respectively. There was significant difference between the two groups (all P <0.05). In the observation group, the intraoperative urine output was (337.5 ± 69.4) ml and the number of clear lymph nodes was (13.2 ± 2.6), both of which were more than that of the control group (251.8 ± 71.0) ml and (11.0 ± 1.8) The incidence of postoperative complications was 2.2%, which was lower than that of the control group (15.2%). There was significant difference between the two groups (all P <0.05). Conclusions Laparoscopic surgery is more effective and safer than wide-excision of uterus.