摘要
目的 :回顾分析外阴恶性肿瘤外科治疗的预后及其影响因素。方法 :回顾分析了山东省肿瘤医院 1971～ 1999年收治的 71例经手术治疗的外阴恶性肿瘤患者临床资料。结果 :中位发病年龄 5 7 9岁 ;Ⅰ期 8例、Ⅱ期 32例、Ⅲ期 2 2例、Ⅳ期 6例、复发者 3例 ;鳞癌 5 2例、恶性黑色素瘤 9例、其他类型 10例 ;行腹股沟淋巴结清除术者 4 5例 ,未清除者 2 6例。外阴区伤口Ⅰ期愈合 5 7例 (80 % ) ,腹股沟区伤口Ⅰ期愈合 32例 (71.1% )。总 5年生存率为 5 0 9% (2 9/ 5 7) ,较早期 (Ⅰ、Ⅱ )患者 5年生存率均高于晚期 ,伤口愈合情况对预后有一定的影响。结论 :①早期发现、早期诊断、早期治疗对外阴癌的治疗预后尤为重要。②手术切除是外阴癌的主要治疗手段 ,手术方式的选择应个体化 ,对病期较早淋巴结转移率小的患者可试行单纯外阴切除 ,术后给予放疗或化疗。③外阴复发癌亦应积极创造再治疗机会 ,如处理得当 ,可挽救或延长患者生命。④加强护理 ,促进伤口愈合 。
Objective Retrospectively analyze the prognosis and relative prognostic factors for patients with malignancies of the vulvae treated by surgery.Methods The authors analyzed retrospectively the clinical material of the 71 patients with malignancies of the vulvae treated surgically from 1971 to 1999.Results The median onset age of the patients was 57 9 years old,had stage Ⅰ 8 patients,stage Ⅱ 32,stage Ⅲ 22,and stage IV 6 Recurrence was defined in 3 cases.Pathologically,there were 52 squamous cell carcinomas,9 malignant melanomas,and 10 other types.Of the patients,dissection of inguinal lymph nodes was finished in 45 cases,and 26 cases did not undertaken the dissection.I stage heal up of the vulvae incision occurred in 57 patients (80%),and I stage heal up of the inguinal incision occurred in 32 patients (71 1%).The overall 5 year survival rate was 50 9%(29/57),and the survival of patients with early stages (I and Ⅱ ) was superior to the advanced.The healing up status of the incision influenced the patients'prognosis partly.Conclusions It is very important for malignancies of the vulvae to diagnose and treat early.Surgical excision is the main treatment approach,the selection of operative patterns should be individualized.Single excision of the vulvae combined with postoperative radiotherapy or chemotherapy can be tried for patients with early stage of lesion and little possibility of locoregional lymph node metastases.It is necessary to creat the opportunity of retreatment for the recurrences of the vulvae,and,if managed correctly,the survival can be improved.To intensify nursing for the patient and accelerate healing of the incision is favorable to improve survival rate of the patients.
出处
《肿瘤防治杂志》
2002年第4期436-438,共3页
China Journal of Cancer Prevention and Treatment
关键词
外阴肿瘤
外科学
护理
预后
治疗
vulvar neoplasms/surgery
nursing care
prognosis
