腹腔镜与经腹子宫颈癌根治术的临床对比分析

目的：比较宫颈癌Ia～Ⅱb期腹腔镜与经腹行根治手术的临床治疗效果。方法：回顾性分析2000年3月-2011年12月本院宫颈癌Ia～Ⅱb腹腔镜行根治术135例与经腹子宫颈癌根治术65例的临床资料,分析宫颈癌两种术式的手术时间、术中出血量、术中尿量、术中输液量、术后排气时间、发热天数、下床活动时间、血红蛋白变化、保留尿管时间、术前后血红蛋白变化,残余尿量、淋巴结清除术数目、术中输血率、住院天数、术后镇痛药物使用及术中、术后并发症的发生率。结果：腹腔镜组术中出血量（214.61±137.81）ml,术后肛门排气时间平均（1.55±0.73）d,术中、术后近期并发症等均低于经腹组,两组比较差异均有统计学意义（P〈0.05）;术中尿量,阴道残端病灶的复发、直肠功能紊乱、膀胱功能紊乱等远期并发症各项指标两组差异无统计学意义（P〉0.05）。结论：腹腔镜手术在妇科恶性肿瘤的治疗中具有创伤小、出血少,腹腔内环境干扰小、恢复快、腹部无瘢痕等优点,术后患者的依从性好,有利于术后的康复。

A Comparative Study of Laparoscopic Radical Hysterectomy with Radical Abdom Hysterectomy for Cervical Cancer

Objective：To compare clinical curative effect of the laparoscopic radical hysterectomy（LRH）and radical abdominal hysterectomy （RAH）for IA-Ⅱ B-stage cervical cancer.Method：We performed a retrospect review of all patient who underwent laparoscopic and laparotomic radical hysterectonry at our hospital between March 2000 and December 2011,200 patients with cervical carcinoma were reviewed,65 of whom underwent RAH and 135 of who were tread by LRH.The operative parameters including operative time ,intraperative blood loss ,Intraoperative urine,intraoperative transfusion volume,postoperative exhaust time,hot days,the bed activity time,hemoglobin change,retained ureter time,after the preoperative hemoglobin change,residual urine,lymph node number of operation,intraoperative blood transfusion rate,hospitalization days,postoperative analgesia drug use and intraoperative and postoperative complications incidence.Result：In laparoscopic group during the operation,the amount of blood loss were（214.61 ±137.81）ml,postoperative anal exhaust time average were（1.55±0.73）d,intraoperative and postoperative complications lower than recent abdominal group,two groups of comparisons difference have statistical significance（ P〈0.05）;Intraoperative urinary quantity,vaginal residual end lesions recurrence,rectal function disorder,bladder dysfunction and long-term complications each index two groups was statistically significant differences（ P〈0.05）.Conclusion：Laparoscopic surgery in the treatment of gynecologic malignant tumors with small trauma,less bleeding,abdominal little interference environment,rapid recovery,and no scar abdominal etc,and the patients compliance is good,be helpful for postoperative rehabilitation.