全直肠系膜切除结合盆腔自主神经保护对排尿功能影响的初步研究

Initial Research on the Influence of Urinary Function after PANP(Pelvic Autonomic Nerve preservation) and TME(Total Mesorectal Excision)

目的:初步探讨在全直肠系膜切除基础上保留盆腔自主神经,治疗直肠癌的方法以及对近期排尿功能的影响。方法:我科2005年的直肠癌患者20例,手术以全直肠系膜切除原则为基础,主要保留的神经有:上腹下丛、腹下神经、盆丛、盆内脏神经。20例患者手术前7天,手术后14天分别行尿流率、尿动力测定,收集尿流率、残余尿、逼尿肌收缩压、排尿压等指标。结果:比较手术前后最大尿流率、残余尿、逼尿肌收缩压、排尿压,差异无统计学意义(P>0.05)。结论:全直肠系膜切除结合盆腔自主保护对排尿功能影响较小,能够保护直肠患者的排尿功能。

Objective： the purpose of the initial research lies in retaining the methods pelvic autonomic nerve cure Rectal Cancer and the influence of urinary function in the near future. Methods： In 2005, My department operated on 20 Rectal Cancer examples for PANP and TME, On the basis of TME principle, The main retention nerves have ： Superior hypogastric plexus nerve, Hypogastric nerves,Pelvic plexus,Pelvic splanchnic nerves. All the cases, preoperative （7 days）, postoperative （14 days）, test urinary flow rate, urinary motivation and gather the consequences- urinary flow rate, residual urine, contractive pressure of detrusor muscle, et al. Results： The maximunm urinary flow rate; residual urinecontractive pressure of detrusor muscle; emiction pressure; All these differences mentioned above have no significance （p 〉 0.05）. Conclusion： PANP and TME can cause a little influence on urinary function and they can protect urinary function of rectum patients effectively.