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术中电刺激在系统保留盆腔自主神经根治性子宫切除术中的应用及价值 被引量:4

The application of intraoperative electrical stimulation during systematic nerve-sparing radical hysterectomy.
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摘要 目的评估在系统保留盆腔自主神经的根治性子宫切除术(SNSRH)中应用术中电刺激(IES)技术识别并确认副交感神经通路成功保留的可行性。方法对2008年6月至2009年4月在南方医科大学南方医院妇产科住院的18例宫颈癌及2例子宫内膜癌患者行SNSRH手术,子宫切除后使用cadwell cascade神经监护仪电刺激盆腔内脏神经(PSN)主干根部并同时记录膀胱逼尿肌肌电(EMG)活动,观察患者术后第8天的残余尿量、残余尿量≤50mL的保留尿管时间、排气及排便时间。结果20例患者中,18例在子宫切除后电刺激PSN主干根部成功诱发膀胱逼尿肌产生EMG活动,定义为电刺激阳性,该组患者术后第8天残余尿量平均为(148.83±141.81)mL,残余尿量≤50mL时保留尿管时间为(9.89±2.70)d,排气时间为(60.29±22.73)h,排便时间为(104.29±37.60)h。另2例电刺激PSN主干根部无法诱发膀胱逼尿肌产生EMG活动,定义为电刺激阴性,这2例患者第8天残余尿量分别为580mL和210mL,保留尿管时间分别为19d和25d。结论在SNSRH术中,IES能够确定副交感神经通路是否成功保留,并可以预测患者术后膀胱功能的恢复情况。 Objective To evaluate the feasibility for confirming the preservation of the parasymphathetic nerve pathway during systematic nerve-sparing radical hysterectomy (SNSRH) using intraoperative electrical stimulation(IES). Methods Eighteen patients with cervical cancer and two patients with endometrial carcinoma underwent SNSRH. IES were performed on pelvic splanehnic nerve (PSN) while recording the electromyographyic (EMG) activity of the vesical detrusor using neurological monitoring system. The residual urine at eighth day, the duration of postoperative catheterization, the first exhaust time and stool time were observed. Results Evokable potentials were recorded in 18 out of 20 patients, called IES-positive. Its residual urine at eighth day was ( 148.83 ± 141.81 ) mL. The average duration of postoperative catheterization was (9.89 ± 2.70) days. The first exhaust time and stool time were (60.29 ± 22.73 ) and ( 104. 29 ± 37.60) hours respectively. For the remaining 2 IES-negative patients, the residual urine was 580mL and 210mL. The durations of postoperative catheterization were 19 and 25 days respectively. Conclusion During SNSRH, IES based on the measurement of EMG activity is a useful tool for confirmation of the preservation of the parasymphathetie nerve pathway innervating the bladder and prediction of the postoperative bladder function.
出处 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2009年第12期906-910,共5页 Chinese Journal of Practical Gynecology and Obstetrics
基金 广东省科技计划(2009B030801227)
关键词 根治性子宫切除术 保留盆腔自主神经 术中电刺激 副交感神经 radical hysterectomy pelvic autonomic nerve intraoperative electrical stimulation parasymphathetic nerve
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参考文献15

  • 1Pieterse QD, Maas CP,ter Kuile MM. An observational longitudinal study to evaluate miction, defecation, and sexual function after radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer[ J ]. Int J Gynecol Cancer, 2006,16 ( 3 ) : 1119- 1129.
  • 2Ditto A, Martinelli F, Bnrreani C,et. al. Quality of life and sexual, bladder, and intestinal dysfunctions after class Ⅲ nerve-sparing and class Ⅱ radical hysterectomies [ J ]. Int J Gynecol Cancer,2009,19(5) :953-957.
  • 3Dursun P,Ayhan A, Kuscu E. Nerve-sparing radical hysterectomy for cervical carcinoma[ J]. Critical Reviews in Oncology/Hematology,2009,70 : 195-205.
  • 4Fujii S,Takakura K, Matsunmra N,et al. Anatomic identification and functional outcomes of the nerve sparing Okabay, ashi radical hysterectomy [ J ]. Gynecol Oncol,2007 ( 107 ) :4-13.
  • 5Raspagliesi F, Ditto A, Fontanelli R, et al. Nerve-sparing radical hysterectomy: a surgical technique for preserving the autonomic hypogastric nerve [ J ]. Gynecol Oncol, 2004,93 : 307-314.
  • 6陈春林,郭红霞,刘萍,黄劲松,黄睿,李峰娟,苏桂栋,余艳红,钟梅,刘国炳,林健,张雪玉,徐燕,孔欣.根治性子宫切除术中系统保留盆腔自主神经的临床研究[J].中国实用妇科与产科杂志,2009,25(3):206-209. 被引量:20
  • 7黄睿,赵杉珊,陈春林,刘萍.系统保留盆腔自主神经的广泛性子宫切除术[J].中国实用妇科与产科杂志,2008,24(3):233-235. 被引量:15
  • 8Dursun P, Ayhan A, Kuscu E. Nerve-sparing radical hysterectomy for cervical carcinoma[ J ]. Critical Reviews in Oncology/Hematology,2009,70 : 195-205.
  • 9Sakuragi N,Todo Y, Kudo M, et al. A systematic nerve-sparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgieal bladder function [ J]. Int J Gynecol Cancer, 2005,15(2) :387-97.
  • 10Colletti V, Fiorino FG. Advances in monitoring of seventh and eighth cranial nerve function during posterior fossa surgery[ J]. Am J Otol, 1998,19:503-512.

二级参考文献30

  • 1邱实,王金兰,王永奎,范天生,吴义勋,乔玉环,董长江.与子宫颈癌手术有关部位的盆丛神经分布定性定量研究[J].中国临床解剖学杂志,1994,12(1):17-20. 被引量:18
  • 2臧荣余,程玺,汤洁,杨慧娟.子宫次广泛/广泛切除手术保留盆腔植物神经对膀胱功能恢复保护作用的初步观察[J].现代妇产科进展,2006,15(10):773-775. 被引量:21
  • 3Piver MS, Rutledge F, Smith JP. Five classes of extended hysterectomy for women with eervieal cancer [ J ]. Obstet Gynecol, 1974,44:265-262.
  • 4Possover M, Stober S, Plaul K, et al. Identification and preservation of the motoric innervation of the bladder in radical hysterectomy type Ⅲ [ J ]. Gynecol Oncol,2000,79 ( 2 ) : 154-157.
  • 5Kuwabara Y, Suzuki M, Hashimoto M, et al. New method to prevent bladder dysfunction after radical hysterectomy for uterine cervical cancer[ J]. J Obstet Gynaecol Res,2000,26 (1): 1-8.
  • 6Raspagliesi F, Ditto A, Fontanelli R, et al. Nerve-sparing radical hysterectomy: a surgical technique for preserving the autonomic hypogastric nerve[ J]. Gynecol Oncol,2004, ;93 ( 2 ) :307-314.
  • 7Sakuragi N, Todo Y, Kudo M, et al. A systematic nerve-sparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgical bladder function [ J ]. Int J Gynecol Cancer, 2005,15(2) :387-397.
  • 8Boyce WH.Bladder electromyography:a new approach to the diagnosis of urinary bladder dysfunction[J].J Urol,1952,67:650-671.
  • 9Hashitani H,Brading AF.Electrical properties of detrusor smooth muscles from the pig and human urinary bladder[J].Br J Pharmacol,2003,140(1):146-158.
  • 10Sui GP,Wu C,Fry CH.The electrophysiological properties of cultured and freshly isolated detrusor smooth muscle cells[J].J Urol,2001,165(2):627-632.

共引文献34

同被引文献35

  • 1吴义勋,邱实,孟君.宫颈癌根治术对盆丛神经的损伤及其预防[J].中华肿瘤杂志,1994,16(6):465-468. 被引量:74
  • 2吴琨,章文华,张蓉,李华,白萍,李晓光.219例子宫颈癌根治术的并发症分析[J].中华肿瘤杂志,2006,28(4):316-319. 被引量:63
  • 3董新舒.男性直肠癌直肠全系膜切除方法与盆腔神经丛保护[J].中国实用外科杂志,2007,27(6):457-459. 被引量:9
  • 4Li S,Hu T,Lv W,et al.Changes in prevalence and clinical characteristies of cervical cancer in the People's Republic of China:study of 10012 cases from a nationwide working group[J].Oncol,2013,18(10):1101-1107.
  • 5Sakamoto S,Takizawa K.An improved radical hysterectomy with fewer gicalcomplications and with no loss of therapeutic results for invasive cervical cancer[J].Ballieres Clin Obstet Gynaecol,1988,2(4):953-962.
  • 6Hockel M,Konerding MA,Heussel CP.Liposuction-assisted nerve-sparing extendend radical hysterectomy:oncologic rationale surgical anatomy,and feasibility study[J].Am J Obstet Gynecol,1998,178(5):971-976.
  • 7Liang Z,Chen Y,Xu H,et al.Laparoscopic nerve-sparing radical hysterectomy with fascia space dissection technique for cervical cancer description of technique and outcomes[J].Gynecol Oncol,2010,119(2):202-207.
  • 8Sakuragi N,Todo Y,Kudo M,et al.Aststematic nervesparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgical bladder function[J].Int J Gynecol Cancer,2005,15(2):387-397.
  • 9Katahira H,Niikuraa Y,Kaihob H,et al.Intraoperative electrical stimulation of the pelvic splanchnic nerves during nervesparing radical hysterectomy[J].Gynecol,2005,98(3):462-466.
  • 10Possover M,Quakemack J,Chiantera V.The LANN technique to ruduce postoperative functional morbidity in laparoscopic radical peivic surgery[J].J AM Coll Surg,2005,201(6):913-917.

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