腹腔镜下保留盆腔自主神经广泛性子宫切除术治疗宫颈癌的效果

The effect of laparoscopic pelvic autonomic nerve-preserving extensive hysterectomy for cervical cancer

目的探讨腹腔镜下保留盆腔自主神经广泛性子宫切除术对宫颈癌患者的治疗效果。方法选取2017年2月—2019年6月上饶市第五人民医院收治的70例宫颈癌患者作为研究对象,采用随机数字表法分为对照组(35例)和观察组(35例)。对照组接受传统腹腔镜下广泛性子宫切除术治疗,观察组接受腹腔镜下保留盆腔自主神经广泛性子宫切除术,术后随访时间均为7 d。比较两组手术相关情况、术后尿流动力学指标、术后膀胱功能、术后直肠功能。结果观察组手术用时长于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。术后,观察组每日排尿次数少于对照组,差异有统计学意义(P<0.05);术后,残余尿量、初始尿意时膀胱容量、强烈尿意时膀胱容量小于对照组,每日最大排尿量大于对照组,差异有统计学意义(P<0.05)。术后,观察组腹压排尿、尿潴留、膀胱功能障碍、尿失禁发生率低于对照组,差异有统计学意义(P<0.05)。术后,观察组排便时间和排气时间短于对照组,差异有统计学意义(P<0.05)。两组阴道切除长度和术中失血量比较,差异无统计学意义(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在治疗宫颈癌时对患者的尿路功能、直肠功能、膀胱功能影响小,患者住院时间短,且治疗效果较好。

Objective To explore the effect of laparoscopic pelvic autonomic nerve-preserving extensive hysterectomy on patients with cervical cancer.Methods A total of 70 patients with cervical cancer admitted to the Fifth People′s Hospital of Shangrao City from February 2017 to June 2019 were selected and divided into the control group(35 cases)and the observation group(35 cases)according to the random number table method.The control group received extensive hysterectomy under traditional laparoscopic surgery treatment,and the observation group received laparoscopic extensive hysterectomy with preserving pelvic autonomic nerve treatment.The postoperative follow-up time was 7 days.The surgery related conditions,postoperative urodynamic indexes,postoperative bladder function,postoperative rectal function before and after treatment were compared between the two groups.Results The time of operation in the observation group was longer than that of the control group,and the time of hospital stay in the observation group was shorter than that of the control group,the differences were statistically significant(P<0.05).After the surgery,the frequency of urination daily in the observation group was less than that of the control group,the difference was statistically significant(P<0.05).After the surgery,the residual urine volume,the bladder capacity during initial urge to urinate,and the bladder capacity at initial urinary intention in the observation group were smaller than those of the control group,the maximum urination volume daily in the observation group were greater than those of the control group,the differences were statistically significant(P<0.05).After the surgery,the incidences of abdominal pressure,urinary retention,bladder dysfunction,and urinary incontinence in the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).After the surgery,the defecation time and exhaust time in the observation group was shorter than that of the control group,and the differences were statistically significant(P<0.05).There were no statistically significant in vaginal resection length and intraoperative blood loss between the two groups(P>0.05).Conclusion Laparoscopic pelvic autonomic nerve-preserving extensive hysterectomy has little effect on the patient′s urinary tract function,tectal function,bladder function in the treatment of cervical cancer,the patient′s hospital stay is short,and the treatment effect is better.