摘要
目的:探究多孔腹腔镜(MPLS)下全子宫切除术治疗早期子宫内膜癌(EC)预后影响因素。方法:回顾性分析2020年1月-2023年3月本院收治的行手术治疗早期EC患者110例临床资料,依据手术方式将行MPLS全子宫切除术治疗的患者设为MPLS组(n=62),行传统开腹手术治疗的患者设为开腹组(n=48)。比较两组手术相关指标、术后膀胱功能、术前与术后排尿及生活质量综合评定问卷(GQOLI-74)评分情况。MPLS组根据随访1年预后情况,将出现复发或死亡患者设为预后不良组,余为预后良好组,多因素logistic回归分析MPLS全子宫切除术治疗早期EC不良预后影响因素。结果:与开腹组相较,MPLS组术中出血量和膀胱剩余尿量明显降低,手术、留置导尿管、初次排尿、排尿完全恢复及出院时间均明显缩短(P<0.05);两组术后排尿功能相关指标自由尿流率、充盈时膀胱压、排尿期同步压力流率均改善,GQOLI-74评分提高,且MPLS组效果更佳(均P<0.05);多因素logistic回归分析,年龄≥60岁(OR=3.861,95%CI 1.685~8.847)、临床分期Ⅰb期(OR=1.960,95%CI 1.191~3.225)、术前糖类抗原125≥35μg/ml(OR=4.604,95%CI 1.986~10.674)为早期EC患者MPLS全子宫切除术后发生不良预后的独立危险因素(P<0.05)。结论:MPLS下全子宫切除术治疗早期EC效果显著,临床分期Ⅰb期、年龄≥60岁、术前糖类抗原125≥35μg/ml为影响MPLS全子宫切除术治疗不良预后的独立危险因素。
Objective:To investigate the prognostic influence factors of the multi-port laparoscopic surgery(MPLS)of total hysterectomy for treating patients with early endometrial cancer(EC).Methods:The clinical data of 110 patients with early EC who received surgical treatment in the hospital from January 2020 to March 2023 were analyzed retrospectively.According to the different surgical method,62 patients who underwent MPLS of total hysterectomy were in study group and 48 patients who received traditional laparotomy were in control group.The surgery-related indexes,the postoperative bladder function,the urination situation before and after surgery and the score of generic quality of life inventory-74(GQOLI-74)of the patients were compared between the two groups.According to the prognosis status of the patients in the study group after l year of follow-up,the patients with recurrence of EC or death were included in group A and the other patients without recurrence of EC or death were included in group B.Multivariate logistic regression analysis was performed to analyze the independent risk factors leading to the poor prognosis of the patients with the early EC after MPLS total hysterectomy.Results:The intraoperative blood loss and the residual urine volume of bladder of the patients in the study group were significantly lower than those of the patients in the control group.and the operation time,the indwelling catheter time,the first urination time,the full urination recovery time and the discharge time of the patients in the study group were significantly less than those of the patients in the control group(P<0.05).The postoperative urination function related indexes,such as the free urinary flow rate,the bladder pressure during flling,the synchronous pressure flow rate during urination and GQOLI-74 score of the patients in the two groups had improved significantly,and the effect of which of the patients in the study group was better than that of the patients in the control group(all P<0.05).Multivariate logistic regression analysis showed that the age≥60 years old(OR=3.861,95%CI:1.685-8.847),the percentage of the clinical stage I b(OR=1.960,95%CI:1.191-3.225)and the preoperative carbohydrate antigen 125 level≥35μg/ml(OR=4.604,95%CI:1.685-3.847)of the patients with early EC were the independent risk factors of their poor prognosis after hysterectomy under MPLS(P<0.05).Conclusion:The total hysterectomy under MPLS for treating the patients with early EC has significant effect.The clinical stage I b,the age≥60 years old and the preoperative carbohydrate antigen 125 level≥35μg/ml of the patients with early EC are the independent risk factors of their poor prognosis after hysterectomy under MPLS.
作者
彭友晋
王玲玲
PENG Youjin;WANG Lingling(Guang'an People's Hospital,Guang'an,Sichuan Province,638000)
出处
《中国计划生育学杂志》
2025年第6期1396-1401,共6页
Chinese Journal of Family Planning
关键词
子宫内膜癌
多孔腹腔镜全子宫切除术
临床疗效
预后
影响因素
Endometrial carcinoma
Multi-port laparoscopic total hysterectomy
Clinical efficacy
Prognosis
Influencing factor
