摘要
目的:讨论保留自主神经的直肠癌根治术对排尿功能的影响。方法:回顾性分析全直肠系膜切除术结合盆腔自主神经保护(TME+PANP组)和全直肠系膜切除术(TME组)术前7 d、术后14 d尿流动力学变化,评估对排尿功能的影响,其主要指标有:最大尿流率、最大尿流率时排尿压、膀胱容积、残余尿量。结果:TME+PANP组:最大尿流率:术前(19.7±6.6)mL/s,术后(14.2±6.0)mL/s,差异有统计学意义(P<0.05);最大尿流率时的排尿压:术前(35.3±20.3)cm H2O,术后(33.1±18.6)cm H2O,差异无统计学意义(P>0.05);膀胱剩余容积:术前(358±35)mL,术后(342±39)mL,差异无统计学意义(P>0.05);残余尿量:术前(9.4±5.7)mL,术后(11.1±8.4)mL,差异无统计学意义(P>0.05)。TME组:最大尿流率:术前(17.8±6.2)mL/s,术后(12.5±5.4)mL/s,差异有统计学意义(P<0.05);最大尿流率时的排尿压:术前(32.8±18.2)cm H2O,术后(25.4±17.5)cm H2O,差异有统计学意义(P<0.05);膀胱剩余容积:术前(354±38)mL,术后(297±40)mL,差异有统计学意义(P<0.05);平均残余尿量:术前(9.8±6.1)mL,术后(10.2±7.9)mL,差异无统计学意义(P>0.05)。TME+PANP组与TME组术后比较:术后最大尿流率、最大尿流率时排尿压、膀胱剩余容积,TME+PANP组均大于TME组,且差异有统计学意义(P<0.05)。结论:保留盆腔自主神经的直肠癌根治术可以较好地改善排尿功能。
Objective: Discuss impaction on urinary function of pelvic autonomic nerve preservation.Methods: Retrospectively analyze preoperative and postoperative urodynamic changes between 20 patients with pelvic autonomic nerve preservation(TME+PANP) and 20 patients just received total mesorectal excision(TME).Results: TME+PANP: The mean maximal flow rate: preoperative(19.7±6.6) mL/s,postoperative(14.2±6.0) mL/s,P〉0.05;the urinary pressure of maximum flow rate: preoperative(35.3±20.3) cm H2O,postoperative(33.1±18.6) cm H2O,P〈0.05;The mean voided volume: preoperative(358±35) mL,postoperative(342±39) mL,P〈0.05;The mean residual urine volume: preoperative(9.4±5.7) mL,postoperative(11.1±8.4) mL,P〈0.05.TME: The mean maximal flow rate: preoperative(17.8±6.2) mL/s,postoperative(12.5±5.4) mL/s,P〈0.05;The urinary pressure of maximum flow rate: preoperative(32.8±18.2) cm H2O,postoperative(25.4±17.5) cm H2O,P〈0.05;The mean voided volume: preoperative(354±38) mL,postoperative(297±40) mL,P〈0.05;The mean residual urine volume: preoperative(9.8±6.1) mL,postoperative(10.2±7.9) mL,P〈0.05.As for postoperative indexes,the mean maximal flow rate,the urinary pressure of maximum flow rate and the mean voided volume of TME+PANP group are larger than TME group,P〈0.05.Conclusion: Patients' urinary function after radical resection can be effectively improved by pelvic autonomic nerve preservation.
出处
《中国现代普通外科进展》
CAS
2010年第10期783-786,共4页
Chinese Journal of Current Advances in General Surgery
关键词
直肠肿瘤
全直肠系膜切除
盆腔自主神经保护
尿流动力学
Rectal neoplasms·Total mesorectal excision·Pelvic autonomic nerve preservation·Urodynamics