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目的:比较盆腔淋巴结切除术中丝线结扎和电凝闭合盆腔淋巴管断端术后盆腔淋巴囊肿形成的情况,从而找到更有效预防盆腔淋巴囊肿的方法。方法:选取南阳市中心医院妇产科2008年6月～2010年12月接受盆腔淋巴结切除术的宫颈癌患者。研究组42例,术中用4号丝线结扎双侧腹股沟深淋巴管、闭孔近端淋巴管、闭孔远端淋巴管、髂总淋巴管、髂内外静脉交叉处淋巴管共5处;对照组36例,术中用电凝闭合相应淋巴管。于手术后第1周、第4周、第12周和第24周对患者进行体格检查和B超检查,了解盆腔有无淋巴囊肿形成以及有无其他相关并发症的发生。结果:丝线结扎组与电凝闭合组患者基本情况、术后住院天数、手术时间、术中出血量、术后排气时间、卵巢移位、淋巴结转移,术后引流量比较,无统计学差异。电凝闭合组术后第1周、术后第4周、第12周淋巴囊肿形成率高于结扎组;术后第24周电凝闭合组与结扎组淋巴囊肿形成率无统计学差异。结论:盆腔淋巴结切除术中丝线结扎腹股沟深淋巴管、闭孔近端淋巴管、闭孔远端淋巴管、髂总淋巴管、髂内外静脉交叉处淋巴管比电凝闭合相应淋巴管在术后近期内可以有效地减少盆腔淋巴囊肿的发生率。
OBJECTIVE: To compare the formation of pelvic lymphatic cysts after silk ligation and electrocoagulation in the pelvic lymphadenectomy to find a more effective method to prevent pelvic lymphatic cyst. Methods: Nanyang Central Hospital Obstetrics and Gynecology from June 2008 to December 2010 to accept pelvic lymph node dissection of cervical cancer patients. The study group consisted of 42 cases. There were 5 lymphatic vessels in bilateral inguinal deep lymphatic vessels, proximal closed-cell lymphatic vessels, distal closed lymphatic vessels, common iliac lymphatic vessels, and internal and external iliac vein ligated with No. 4 silk thread. Group 36 cases, surgery with the corresponding lymphatic drainage closed. At the first week, the fourth week, the twelfth week and the twenty-fourth week after surgery, the patients were examined by physical examination and B-ultrasound to find out whether pelvic lymphatic cyst was formed or not and other related complications. Results: There was no significant difference in the basic conditions, length of postoperative hospital stay, operation time, intraoperative blood loss, postoperative exhaust time, ovarian displacement, lymph node metastasis and postoperative drainage between the ligation group and the electrocoagulation closure group . The incidence of lymphatic cyst formation in the first week, the fourth week and the twelfth week after the operation in the coagulation group was higher than that in the ligation group. There was no significant difference in the rate of lymphatic cyst between the closure group and the ligation group in the 24th week. Conclusions: In the pelvic lymphadenectomy, the lymphatic vessels in the inguinal deep lymphatic vessels, the proximal closed-cell lymphatic vessels, the distal lymphatic vessels in the obturator, the common iliac lymphatic vessels and the lymphatic vessels in the cross of the iliac-external venous veins are shorter than the corresponding lymphatic vessels in the postoperative The near future can effectively reduce the incidence of pelvic lymphatic cysts.