保留盆腔自主神经的宫颈癌广泛性子宫切除术对术后排尿功能的影响

Changes of urinary function after nerve-sparing radical hysterectomy for cervical cancer

目的回顾性分析宫颈癌行保留盆腔自主神经的广泛性子宫切除术（NSRH）和传统的广泛性子宫切除术（RH）对患者术后排尿功能的影响。方法选择临床分期为ⅠB1～ⅡA期并手术的宫颈癌患者57例，其中行NSRH患者31例，传统的RH患者26例，评估患者术后的膀胱功能，比较两种手术方式患者术后排尿功能恢复情况及术后肿瘤复发情况。结果NSRH患者术后尿管留置时间（8．5±3．2）d，传统的RH患者为（12．8±3．8）d，两者比较差异有统计学意义（P〈0．叭）。两种手术方式患者术后随访1—4年，均健在，无肿瘤复发和转移。结论NSRH能较好地保留盆腔的自主神经，较明显改善早期宫颈癌患者术后的排尿功能，并且不影响肿瘤的根治效果。

Objective To retrospectively compare analysis of two kinds of surgery which were nerve-sparing radical hysterectomy （NSRH） and the traditional radical hysterectomy （RH） for cervical cancer was done to find out the effect on urinary function in postoperative patients. Methods Among 57 cervical eaneer with clinical stage ⅠB1～ⅡA 31 cases treated with NSRH,26 eases treated with RH. The postoperative bladder function of the two methods were evaluated, and postoperative recovery of urinary function and postoperative recurrence of tumor were eompared. Results The period of indwelling catheter for the postoperative patients with NSRH was （8.5 ±3.2） days, obviously less than that for traditional RH patients which was （ 12.8± 3.8 ） days. The differenee was statistieally significant（P 〈 0.01 ）. And two methods of postoperative patients were alive without tumor recurrence and metastasis after 1-4 years follow-up. Conclusions NSRH is better than traditional RH in remaining pelvic autonomic nervous system and improving the early urinary function of postoperative patients of eervical cancer. Otherwise, it doesn＇t effect the radical cure of tumor.