術(shù)前介入化療對局部晚期宮頸癌臨床近期療效

蔣明　高小盼　陸曉　來鳳勇

[摘要] 目的 探討術(shù)前介入化療對局部晚期宮頸癌的近期療效。方法 選取入該院治療的局部晚期宮頸癌患者80例作為研究對象，根據(jù)患者意愿分為對照組和觀察組，對照組予以根治術(shù)治療，觀察組予以術(shù)前介入化療聯(lián)合根治術(shù)治療，記錄手術(shù)時間、術(shù)中出血量、平均住院時間，記錄兩組淋巴結(jié)轉(zhuǎn)移情況、宮頸浸潤深度、切緣陽性情況及術(shù)后并發(fā)癥發(fā)生率。 結(jié)果 觀察組手術(shù)時間、術(shù)中出血量及住院時間分別為（165.26±12.84）min、（442.36±26.39）mL、（21.63±4.92）d顯著低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組盆腔淋巴結(jié)轉(zhuǎn)移和宮頸浸潤深度>1/2的幾率分別為7.5%、10.0%顯著低于對照組25.0%、30.0%，差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組術(shù)后并發(fā)癥發(fā)生率為12.5%明顯低于對照組32.5%，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 術(shù)前介入化療可縮小局部病灶，抑制盆腔淋巴結(jié)轉(zhuǎn)移，有利于降低手術(shù)難度。

[關(guān)鍵詞] 宮頸癌；介入化療；根治術(shù)；宮頸浸潤深度；近期療效

[中圖分類號] R6 [文獻標識碼] A [文章編號] 1674-0742（2015）04（c）-0020-02

[Abstract] Objective To explore the short term clinical observation of preoperative interventional chemotherapy on locally advanced cervical cancer. Methods 80 cases of patients with locally advanced cervical cancer were treated in our hospital for treatment as the research object， according to the wishes of patients were randomly divided into control group and observation group， control group was given radical surgery treatment， observation group was given preoperative interventional chemotherapy combined with radical operation in the treatment of bleeding， recorded operation time， intraoperative volume， average hospitalization time， recorded lymph cervical node metastasis， depth of invasion， the incidence of positive margin and postoperative complications of two groups. Results In observation group， operation time， amount of bleeding during the operation and hospitalization time were （165.26±12.84） min， （442.36 ±26.39） mL， （21.63±4.92）d， were significantly lower than control group， the differences were statistically significant（P<0.05）. The pelvic lymph node metastasis and the chance of invasive cervical depth > 1/2 in observation group were respectively 7.5% and 10%， were significantly lower than the control group of 25%， 30%， the differences were statistically significant（P<0.05）. The incidence rate in observation group was 12.5%， was lower than that of control group of 32.5%， the differences were statistically significant（P<0.05）. Conclusion Preoperative induced evolution can reduce the local lesion， inhibition of pelvic lymph node metastasis， which helps to reduce the operation difficulty.

[Key words] Cervical cancer； Interventional chemotherapy； Radical resection； Invasive depth of cervical； Recent curative effect

宮頸癌是婦科常見的惡性腫瘤，發(fā)病率僅次于乳腺癌，具有較高的復(fù)發(fā)率、死亡率。手術(shù)是治療早期頸癌的有效方式，可降低疾病復(fù)發(fā)率。因晚期宮頸癌病灶相對較大，手術(shù)難度相對較大，易損傷輸尿管、膀胱等，且20%左右患者可能出現(xiàn)復(fù)發(fā)、淋巴癌轉(zhuǎn)移等，可能降低5年生存率[1]。目前，新輔助化療逐漸用于化療治療中，可抑制腫瘤生長和遠處轉(zhuǎn)移，提高手術(shù)安全性。文章對比分析了術(shù)前介入化療聯(lián)合根治術(shù)治療局部晚期宮頸癌的近期療效，以提高患者5年生存率，現(xiàn)分析2012年4月—2014年4月間該院收治的宮頸癌Ib～IIb期患者80例的臨床資料，報道如下。

1 資料與方法

1.1 一般資料

隨機選取該院治療的宮頸癌Ⅰb～Ⅱb期患者80例作為研究對象，年齡為35～68歲，平均（46.32±2.68）歲，體重為45～71 kg，平均（59.28±2.69）kg，腫瘤直徑為2.48～7.84 cm，平均（5.18±2.66）cm。……