| 王胜年,李青,钱自强,等.腹腔镜下保留盆腔自主神经广泛性子宫切除术
对早期宫颈癌病人术后生活质量的影响[J].安徽医药,2019,23(5):894-897. |
| 腹腔镜下保留盆腔自主神经广泛性子宫切除术
对早期宫颈癌病人术后生活质量的影响 |
| Effects of laparoscopic extensive hysterectomy with pelvic utonomic nerve preservation on bladder,rectum and sexual function of early cervical cancer patients after operation |
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| DOI：10.3969/j.issn.1009-6469.2019.05.014 |
| 中文关键词: 宫颈肿瘤 腹腔镜检查 子宫切除术 生活质量 内脏神经 腹下丛 膀胱 直肠 性功能 |
| 英文关键词: Uterine cervical neoplasms Laparoscopy Hysterectomy Quality of life Splanchnic nerves Hypogastric plexus Urinary bladder Rectum Sexual function |
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| 中文摘要: |
| 目的 探讨腹腔镜下保留盆腔自主神经广泛性子宫切除术(LNSRH)对早期宫颈癌病人术后膀胱、直肠及性功能的影响。方法 2014年8月至2017年12月安庆市立医院收治的103例早期宫颈癌病人,采用随机数字表法分为两组,其中50例作为观察组(采用腹腔镜下保留盆腔自主神经广泛性子宫切除术),其余53例作为对照组(采用腹腔镜下广泛性子宫切除术),比较两组病人围手术期资料、术后住院天数、术后膀胱功能、直肠功能及性功能恢复情况。结果 对照组手术时间(207.58±44.41) min,术中出血量(132.64±80.08) mL,术后住院天数(9.32±2.98)d,淋巴结切除个数(15.68±7.06)枚;观察组手术时间(258.68±59.89) min,术中出血量(163.60±94.30) mL,术后住院天数(9.00±3.35)d,淋巴结切除个数(14.40±6.07);两组手术时间比较差异有统计学意义(P＜0.05),术中出血量、术后住院天数、切除淋巴结个数比较差异无统计学意义(P＞0.05)。对照组保留尿管时间(17.75±3.61)d,膀胱功能障碍47.2%,腹压排尿26.4%,尿失禁3.8%,尿潴留22.6%;观察组保留尿管时间(11.54±2.38) d,膀胱功能障碍22.0%,腹压排尿10.0%,尿失禁2.0%,尿潴留8.0%,除尿失禁外(P＞0.05),两组比较,均差异有统计学意义(P＜0.05)。观察组排气时间(56.42±8.79) h,排便时间(124.84±14.94) h,均短于对照组的排气时间(79.77±8.73) h和排便时间(160.40±19.337)h(均P＜0.05);术后4个月通过欧洲肿瘤研究与治疗中心宫颈癌病人生活质量问卷表(EORTC QLQ-cx24)评估两组病人术后性生活质量,观察组病人在性活跃度、性愉悦感、性交痛方面优于对照组,差异有统计学意义(P＜0.05)。结论 腹腔镜下保留盆腔自主神经广泛性子宫切除术对病人术后膀胱、直肠及性功能影响较小,可显著提升病人术后生活质量,值得临床推广应用。 |
| 英文摘要: |
| Objective:To investigate the effect of laparoscopic pelvic autonomic nerve-sparing extensive hysterectomy (LNSRH) on postoperative bladder,rectal and sexual function in patients with early cervical cancer.Methods A total of 103 patients with early cervical cancer who were treated in Anqing Municipal Hospital from August 2014 to December 2017 were compared and analyzed.The patients were randomly divided into two groups,in which 50 patients served as the observation group (laparoscopic extensive hysterectomy with pelvic autonomic nerve preservation) and the remaining 53 patients served as the control group (laparoscopic extensive hysterectomy).Perioperative data,postoperative hospital stay,postoperative bladder function,rectal function and sexual function recovery were compared between the two groups.Results In the control group,the operation time was (207.58±44.41) min,intraoperative blood loss was (132.64±80.08) mL,postoperative hospital stay was (9.32±2.98) d,and the number of lymphadenectomy was (15.68±7.06);in the observation group,the operation time was (258.68±59.89) min,intraoperative blood loss was (163.60±94.30) mL,postoperative hospital stay was (9.00±3.35) d,and the number of lymphadenectomy was (14.40±6.07).There was significant difference in the operation time between the two groups (P＜0.05),and no significant difference in the intraoperative blood loss,postoperative hospital stay and the number of resected lymph nodes (P＞0.05).In the control group,the retention time of urinary catheter was (17.75±3.61)d,bladder dysfunction was 47.2%,abdominal pressure urination was 26.4%,urinary incontinence was 3.8%,urinary retention was 22.6%.In the observation group,the retention time of urinary catheter was (11.54±2.38) d,bladder dysfunction was 22.0%,abdominal pressure urination was 10.0%,urinary incontinence was 2.0%,urinary retention was 8.0%.The postoperative indwelling time of urinary catheter,bladder dysfunction,abdominal pressure urination and urinary retention in the observation group were all superior to those in the control group,and the differences had statistical significance (P＜0.05).In the control group,the duration of evacuation was (79.77±8.73)h,duration of defecation was (160.40±19.337)h,duration of evacuation was (56.42±8.79)h,duration of defecation was (124.84±14.94)h,duration of defecation was shorter than that in the control group,and the difference between the two groups had statistical significance(P＜0.05).The patients in the observation group were superior to the control group in terms of sexual activity,sexual pleasure and dyspareunia,and the differences were statistically significant (P＜0.05).Conclusion Laparoscopic extensive pelvic autonomic nerve-sparing hysterectomy has little effect on postoperative bladder,rectum and sexual function,which can significantly improve postoperative quality of life and is worthy of clinical application. |
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