论文部分内容阅读
目的探讨子宫颈癌患者手术并发症的发生原因及其防治策略。方法回顾性分析2003年1月至2008年4月间311例接受子宫颈癌根治术患者的资料,其中ⅠA2期10例,占3.21%;ⅠB1期88例,占28.29%;ⅠB2期42例,占13.50%;ⅡA期(局部病灶≤4cm)127例,占40.84%;ⅡA期(局部病灶>4cm)44例,占14.14%。术后病理类型:鳞癌262例,占84.24%;腺癌37例,占11.90%;腺鳞癌7例,占2.30%;小细胞癌4例,占1.30%。下腹部手术史有96例,占30.87%。本组中,有71例术前接受化疗。结果全组121名患者出现手术并发症,发生率为38.91%;术中并发症有泌尿系损伤、血管损伤;术后并发症以尿潴留、淋巴囊肿、腹部伤口感染为主,发生率分别为13.50%、10.61%和7.07%。在发生术后尿潴留的患者中,术前化疗者29例,占40.85%(29/71),与未接受过新辅助化疗13例(5.42%,13/240)相比较,差异有统计学意义(P=0.011)。结论子宫颈癌根治术后并发症有一定的发生率,与手术范围较大有关;新辅助化疗有可能增加手术并发症。
Objective To investigate the causes and prevention and cure strategies of surgical complications of cervical cancer patients. Methods The data of 311 patients who underwent radical mastectomy for cervical cancer from January 2003 to April 2008 were retrospectively analyzed. Among them, 10 cases were stage IA2, accounting for 3.21%; 88 cases were stage IB, accounting for 28.29%; 42 cases were stage IB2, Accounting for 13.50%; ⅡA stage (local lesion ≤ 4cm) 127 cases, accounting for 40.84%; ⅡA stage (local lesions> 4cm) 44 cases, accounting for 14.14%. Postoperative pathological types: 262 cases of squamous cell carcinoma, accounting for 84.24%; 37 cases of adenocarcinoma, accounting for 11.90%; adenosquamous carcinoma in 7 cases, accounting for 2.30%; small cell carcinoma in 4 cases, accounting for 1.30%. There were 96 cases of lower abdominal surgery, accounting for 30.87%. In this group, 71 patients underwent preoperative chemotherapy. Results Complications occurred in 121 patients (38.91%) in the whole group. The intraoperative complications were urinary tract injury and vascular injury. The postoperative complications were mainly urinary retention, lymphatic cyst and abdominal wound infection, the incidence rates were 13.50%, 10.61% and 7.07% respectively. Among the patients with postoperative urinary retention, preoperative chemotherapy in 29 cases, accounting for 40.85% (29/71), compared with 13 cases without receiving neoadjuvant chemotherapy (5.42%, 13/240), the difference was statistically significant Significance (P = 0.011). Conclusion Complications after radical operation of cervical cancer have a certain incidence, which is related to the larger scope of surgery. Neoadjuvant chemotherapy may increase the complication of operation.