不同手术方式治疗早期宫颈癌的近、远期疗效及术后生活质量的影响

目的 分析不同的手术方式治疗早期宫颈癌患者的近、远期临床疗效及术后生活质量的影响.方法 选取257例早期宫颈癌患者进行研究,按随机数字法分为对照组和观察组.对照组患者行开腹手术,观察组患者行腹腔镜手术.记录两组患者术中和术后的相关手术指标;出院后,并对患者进行1月/次的定期电话回访或检查,记录患者治疗后3个月、6个月及1年的FACT-G评分.结果 术中观察组手术时间(243.56±51.24)min]、清扫淋巴结个数(24.56±4.71)个],明显多于对照组的手术时间(161.87±42.39)min]、清扫淋巴结个数(19.37±3.56)个];但观察组的术中出血量(317.82±51.36)ml]少于对照组术中出血量(352.44±62.17)ml](P<0.05).术后,观察组排气时间(47.59±7.82)h、住院时间(7.45±2.13)d及并发症总发生率(3.75%),明显低于对照组的排气时间(60.27±11.56)h、住院时间(10.78±2.39)d、并发症总发生率10.31%(P<0.05)].观察组的术后3个月、6个月及1年的FACT-G评分与对照组比较无明显差异(P>0.05).结论 采用腹腔镜手术治疗早期宫颈癌患者,与开腹手术对比创伤小、恢复快,且患者术后的远期疗效与开腹手术治疗的患者相当,有较好的临床应用前景.

Short-term and Long-term Efficacy of Different Surgical Methods for Early Cervical Cancer and Its Effect on Postoperative Quality of Life

Objective To analyze the short-term and long-term efficacy of different surgical methods for early cervical cancer and its effect on postoperative quality of life. Methods 257 cases of patients with early cervical cancer were selected and randomly divided into the control group and the observation group. The control group was treated with laparotomy,and the observa-tion group was treated with laparoscopic surgery. Intraoperative and postoperative related indicators of surgery were recorded,after discharge,and the patients receivedregular telephone visit or examination once a month,the patients were recorded for 3 months, 6 months and 1 years of FACT-G score. Results During the operation,the operation time (243. 56 ± 51. 24) min,lymph node number (24. 56 ± 4. 71) of the observation group were higher than those of the control group,(161. 87 ± 42. 39) min and (19. 37 ± 3. 56);but intraoperative blood loss of the observation group (317. 82 ± 51. 36) ml was less than those of the control group (352. 44 ± 62. 17 )ml (P< 0. 05). The postoperative exhaust time (47. 59 ± 7. 82) h,hospitalization time (7. 45 ± 2. 13)d and complications rate 3. 75% of the observation group were significantly lower than those of the control group,(60. 27 ± 11. 56) h, (10.78±2.39)dand10.31% (P< 0.05).TherewasnosignificantdifferenceintheFACT-Gscorebetweenthe2groups3 months,6 months and 1 year after surgery (P>0. 05). Conclusion Laparoscopic surgery in the treatment of patients with early cervical cancer,compared with open surgery,has less trauma,faster recovery,and similar long-term efficacy,it has a good clinical prospect.