系统保留盆腔自主神经的宫颈癌广泛性子宫切除术对膀胱功能的影响

Effect of systematic nerve-sparing radical hysterectomy in cervical cancer on bladder function

目的:探讨在宫颈癌患者行广泛性子宫切除术中系统保留盆腔自主神经对膀胱功能的影响。方法:子宫颈癌行广泛性子宫切除术,术中保留盆腔自主神经的宫颈癌患者共38例,取传统广泛性子宫切除术的宫颈癌患者42例作为对照,观察两组患者术后尿动力学变化及膀胱功能恢复时间。结果:保留盆腔自主神经组和传统手术治疗组患者术后10天膀胱无知觉率分别为10.52%和21.43%,差异有统计学意义(P<0.05);两组术后10天平均膀胱容量分别为(214.62±45.36)ml和(389.64±49.47)ml,差异有统计学意义(P<0.05);两组术后膀胱功能恢复正常时间分别为(11.64±2.01)天和(18.64±3.26)天,差异有统计学意义(P<0.05)。结论:广泛性子宫切除术发生膀胱功能障碍,主要是盆腔自主神经的损伤;术中系统保留盆腔自主神经可缩短术后尿潴留时间,有利于术后膀胱功能的恢复。

Objective：To investigate the bladder function rehabilitation in patients of cervical cancer after systematic never-sparing radical hysterectomy.Methods：We compared the urodynamics and bladder function rehabilitation time in 38 cervical cancer patients with systematic nerve-sparing radical hysterectomy and in 42 cervical patients with tradition radical hysterectomy.Results：On the tenth day after radical hysterectomy,the bladder sensation remained lost in never-sparing radical hysterectomy group and in tradition radical hysterectomy group were 10.52% and 21.43%,the mean bladder capacity were（214.62±45.36）ml and（389.64±49.47）ml.The days of bladder function rehabilitation in two groups were（11.64±2.01）and（18.64±3.26）.There were siginificant changes of the bladder sensation remained lost,the mean bladder capacity,and the day of bladder function rehabilitation in two groups（P0.05）.Conclusion：The pelvic autonomic nerve damage is the main cause of bladder dysfunction after radical hysterectomy.The pelvic autonomic nerve preservation in radical hysterectomy could be benefit to reduce the time of urinary retention and to bladder function rehabilitation after operation.