蒋明　高小盼　陆晓　来凤勇

[摘要] 目的 探讨术前介入化疗对局部晚期宫颈癌的近期疗效。方法 选取入该院治疗的局部晚期宫颈癌患者80例作为研究对象，根据患者意愿分为对照组和观察组，对照组予以根治术治疗，观察组予以术前介入化疗联合根治术治疗，记录手术时间、术中出血量、平均住院时间，记录两组淋巴结转移情况、宫颈浸润深度、切缘阳性情况及术后并发症发生率。 结果 观察组手术时间、术中出血量及住院时间分别为（165.26±12.84）min、（442.36±26.39）mL、（21.63±4.92）d显著低于对照组，差异有统计学意义（P<0.05）。观察组盆腔淋巴结转移和宫颈浸润深度>1/2的几率分别为7.5%、10.0%显著低于对照组25.0%、30.0%，差异有统计学意义（P<0.05）。观察组术后并发症发生率为12.5%明显低于对照组32.5%，差异有统计学意义（P<0.05）。结论 术前介入化疗可缩小局部病灶，抑制盆腔淋巴结转移，有利于降低手术难度。

[关键词] 宫颈癌；介入化疗；根治术；宫颈浸润深度；近期疗效

[中图分类号] R6 [文献标识码] A [文章编号] 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

宫颈癌是妇科常见的恶性肿瘤，发病率仅次于乳腺癌，具有较高的复发率、死亡率。手术是治疗早期颈癌的有效方式，可降低疾病复发率。因晚期宫颈癌病灶相对较大，手术难度相对较大，易损伤输尿管、膀胱等，且20%左右患者可能出现复发、淋巴癌转移等，可能降低5年生存率[1]。目前，新辅助化疗逐渐用于化疗治疗中，可抑制肿瘤生长和远处转移，提高手术安全性。文章对比分析了术前介入化疗联合根治术治疗局部晚期宫颈癌的近期疗效，以提高患者5年生存率，现分析2012年4月—2014年4月间该院收治的宫颈癌Ib～IIb期患者80例的临床资料，报道如下。

1 资料与方法

1.1 一般资料

随机选取该院治疗的宫颈癌Ⅰb～Ⅱb期患者80例作为研究对象，年龄为35～68岁，平均（46.32±2.68）岁，体重为45～71 kg，平均（59.28±2.69）kg，肿瘤直径为2.48～7.84 cm，平均（5.18±2.66）cm。……