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目的比较腹腔镜与开腹根治术治疗早期宫颈癌的疗效及安全性。方法将韩城市人民医院确诊的164例早期宫颈癌患者分为观察组和对照组,每组各82例。观察组采用腹腔镜下根治术治疗,对照组采用开腹根治术治疗。观察两组患者5年生存率、转移癌发生率、清扫淋巴结数目、住院时间、手术时间、出血量、术后并发症及术后疼痛时间。结果对照组患者5年生存率为89.7%,转移癌发生率为4.4%;观察组分别为91.6%和2.8%,两组比较,差异无统计学意义(P>0.05)。对照组清扫淋巴结数目为(20.7±1.5)个,手术时间为(294.6±37.2)min,出血量为(564.3±147.1)ml,住院时间为(8.5±3.1)d,术后并发症的发生率为29.3%,术后疼痛时间为(5.2±1.4)d;观察组清扫淋巴结数目为(26.4±1.7)个,手术时间为(280.4±30.6)min,出血量为(348.5±128.6)ml,住院时间为(7.1±2.6)d,术后并发症的发生率为14.6%,术后疼痛时间为(2.1±1.3)d,以上指标两组患者比较差异均有统计学意义(P<0.05)。结论腹腔镜下根治术与开腹根治术在治疗早期宫颈癌方面有同样的安全性和有效性,但是腹腔镜下根治术更利于患者术后康复和减轻术后痛苦,具有开腹根治术无法比拟的优势。
Objective To compare the efficacy and safety of laparoscopy and laparotomy in the treatment of early cervical cancer. Methods 164 cases of early cervical cancer diagnosed by Hancheng People’s Hospital were divided into observation group and control group with 82 cases in each group. The observation group was treated with laparoscopic radical mastectomy and the control group with open radical mastectomy. The 5-year survival rate, the incidence of metastatic cancer, the number of lymph nodes dissected, length of hospital stay, operation time, blood loss, postoperative complications and postoperative pain time were observed. Results The 5-year survival rate was 89.7% in the control group, and the incidence of metastatic cancer was 4.4%. The observation group was 91.6% and 2.8% respectively. There was no significant difference between the two groups (P> 0.05). The number of lymph nodes in the control group was (20.7 ± 1.5), the operation time was (294.6 ± 37.2) min, the amount of bleeding was (564.3 ± 147.1) ml, the hospitalization time was (8.5 ± 3.1) d, the incidence of postoperative complications (29.3%) and postoperative pain time (5.2 ± 1.4) d. The number of lymph nodes in the observation group was (26.4 ± 1.7), the operation time was (280.4 ± 30.6) min and the amount of bleeding was (348.5 ± 128.6) The time was (7.1 ± 2.6) d. The incidence of postoperative complications was 14.6% and the duration of postoperative pain was (2.1 ± 1.3) days. There was significant difference between the two groups in the above indexes (P <0.05). Conclusions Laparoscopic radical mastectomy and open radical mastectomy have the same safety and efficacy in the treatment of early cervical cancer. However, laparoscopic radical mastectomy is more conducive to postoperative rehabilitation and postoperative pain relief, and has the effect of open radical mastectomy Compared to the advantages.