系统性淋巴结清扫术治疗子宫内膜癌的疗效及安全性评价.doc

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1、系统性淋巴结清扫术治疗子宫内膜癌的疗效及安全性评价摘耍：目的：探讨系统性淋巴结清扫术治疗子宫内膜癌的疗效及安全性。方法：回顾性分析78例子宫内膜癌患资料，并根据其淋巴清扫范围的不同分为观察组和对照组。其中观察组患者行系统性淋巴结清扫术，包括盆腔及腹主动脉旁淋巴结清扫术;对照组患者行单纯盆腔淋巴结清扫术，比较两组患者的手术及术后并发症情况、预后情况。结果：观察组手术时间及术中出血量均大于对照组(卩<0.01);观察组淋巴结平均清扫数量为(20.7±3.5)枚，平均淋巴结阳性数量为(1・84±0・37)枚，均明显多于对照组(P<0.01);

2、两组术后并发症比较无统计学差异(P>0.05);观察组3年生存率为90.32%,明显高于对照组(P<0.05);观察组3年复发率为6.45%,明显低于对照组(P<0・05)。结论：系统性盆腔及腹主动脉旁淋巴结清扫术可明显提高阳性淋巴结检出率，而术后并发症并未见明显增多，患者生存率更高，复发少。关键词：系统性淋巴结清扫腹主动脉旁淋巴Abstract:objectivetoinvestigatethesystemiclymphnodecleaningtreatmentthecurativeeffectandsafetyofendome

3、trialcarcinoma・Methodsretrospectiveanalysis78exampleintrauterinemembranecancerdata,andaccordingtothelymphnodecleaningscopedividedintoobservationgroupandcontrolgroup.Theobservationgroupofpatientswithsystemiclymphnodecleaningoperation,includingpelvicandabdominalaortabylymphnodes

4、wereperformed;Controlgrouppatientswithpurepelviclymphnodeswereperformed,comparethesituationofsurgeryandpostoperativecomplicationsintwogroupsofpatients,prognosis・ResuItsobservationgroupoperativetimeandintraoperativebloodlossweregreaterthanthecontrolgroup(P<0.01);Observationg

5、roupaveragecleaningthenumberoflymphnodes(20.7+3.5),theaveragenumberoflymphnodepositivefor(1.84+0.37),weresignificantlymorethanthecontrolgroup(P&It;0.01);Twogroupsofpostoperativecomplicationsisnostatisticaldifference(P>0.05);3yearsurvivalratewas90.32%,theobservationgroupwaso

6、bviouslyhigherthanthatofcontrolgroup(P&It;0.05);Recurrencerateswere6.45%at3years,theobservationgroupwasobviously1owerthanthecontrolgroup(P&It;0.05)・Conclusionsystematicpelvicandabdominalaortabylymphnodecleaningtechniquecanobviouslyincreasetherateofpositive1ymphnodes,andthepost

7、operativecomplicationsdidnotseeobviousincrease,patientssurvivalratehigher,1essrecurrence.Keywords：systemiclymphnodecleaningLymphaticbyabdominalaorta子宫内膜癌为女性常见恶性肿瘤，近年来发病率呈明显上升趋势。尽管子宫内膜癌临床症状典型，早期易于发现，但患者的生存率并未因此上升。手术治疗是早期子宫内膜癌的首选治疗方法，晚期则以放疗为主，同时辅助化疗与激素治疗［1］。但自1988年国际妇产科联盟(FIGO)采

8、用手术病理分期至今，淋巴结切除术切除范围一直存在争议，尤其是针对腹主动脉旁淋巴结切除的必要性存在较大争议。本研究通过回顾性