早期宫颈癌患者术后盆腔淋巴囊肿形成的因素分析

目的探讨影响早期宫颈癌患者手术后盆腔淋巴囊肿形成的因素。方法回顾性分析2013年1月至2017年12月164例早期宫颈癌患者根治术后的病历资料,47例术后发生盆腔淋巴囊肿。采用多因素Logistic回归分析影响宫颈癌根治术后盆腔淋巴囊肿的因素。结果 164例宫颈癌患者中术后共47例发生淋巴囊肿(28. 66%),发生时间为术后7~336天(中位时间为54天)。淋巴囊肿位于右侧盆腔15例,左侧盆腔11例,双侧盆腔21例。淋巴囊肿直径为2. 6~12. 4 cm。单因素分析结果显示不同手术方式、使用器械、盆腔淋巴结切除范围、术后引流时间和术后是否放疗与盆腔淋巴囊肿发生有关(P<0. 05)。Logisitic多因素回归分析结果显示,腹腔镜手术(OR=0. 415)和术中使用超声刀(OR=0. 394)在术后盆腔淋巴囊肿的形成的保护因素(P<0. 05);腹主动脉旁淋巴结清扫(OR=2. 696)、引流管拔出时间(OR=1. 902)与术后放疗(OR=3. 245)为术后盆腔淋巴囊肿形成的独立危险因素(P<0. 05)。结论盆腔淋巴囊肿为宫颈癌根治术后的常见并发症,通过采取个体化的合理治疗措施有助于使盆腔淋巴囊肿的发生率降低。

Analysis of the formation of pelvic lymphocysts in patients with early cervical cancer after surgery

Objective To explore the factors influencing the formation of pelvic lymphocysts in patients with early cervical cancer.Methods Retrospective analysis was performed on the medical records of 164 patients with early cervical cancer from January 2013 to December 2017,and 47 patients developed pelvic lymphocysts after surgery.Multivariate logistic regression analysis was used to analyze the factors affecting pelvic lymphocysts after radical resection of cervical cancer.Results Among the 164 patients with cervical cancer,a total of 47 patients(28.66%)developed lymphocysts after surgery,which occurred between 7 to 336 days after surgery(median time was 54 days).Lymphocysts were found in the right pelvic cavity in 15 cases,the left pelvic cavity in 11 cases,and the bilateral pelvic cavity in 21 cases.The diameter of lymphocysts was 2.6-12.4 cm.The results of single factor analysis suggested that different surgical methods,the use of instruments,the extent of pelvic lymph node resection,postoperative drainage time and postoperative radiotherapy were related to the occurrence of pelvic lymphocysts(P<0.05).Para-aortic lymph node dissection(OR=2.696),drainage tube extraction time(OR=1.902)and postoperative radiotherapy(OR=3.245)were the independent risk factors for postoperative pelvic lymphocyst formation(P<0.05).Conclusion Pelvic lymphocysts is a common complication after radical operation of cervical cancer.The incidence of pelvic lymphocysts can be reduced by individualized reasonable treatment.