保留盆腔自主神经的广泛性子宫切除术临床分析

Clinical analysis of sparing the pelvic autonomic nerve during radical hysterectomy

目的探讨在广泛性子宫切除术中保留盆腔自主神经的临床疗效。方法回顾分析2007年1月-2011年2月我院行广泛性子宫切除术中17例保留自主神经(systematic nerve sparing radical hysterectomy,SNSRH)与25例传统经腹广泛性子宫切除术的临床资料。比较两组手术时间、术中出血、排气时间、留置尿管时间、排便时间等以及手术前后膀胱功能、肛门和(或)直肠功能的变化。结果两组手术切除范围比较无差异,两组切除组织边缘病理表达均无癌细胞浸润。SNSRH组手术时间、排气时间、留置尿管时间、排便时间分别是(238.0±54.0)min、(58.5±20.3)h、(7.8±3.5)d、(90.45±30.5)h;RH组分别为(115.0±39.3)min、(81.3±26.2)h、(17.4±4.5)d、(120.45±23.6)h,两组差异均有统计学意义(P<0.05)。然而出血量无统计学差异。结论在广泛性子宫切除术中保留PAN(pelvic autonomic nerve,PAN)手术效果满意,且膀胱功能以及肛门和(或)直肠功能恢复较快。

Objective To evaluate the clinical effect of sparing the pelvic autonomic nerve（PAN）during radical hysterectomy.Methods From January 2007 to February 2011,17 cases were performed systematic nerve sparing radical hysterectomy（SNSRH）and 25 cases of radical hysterectomy（RH）.The clinical parameters were observed and analyzed,their lower urethra/ bladder and anal/rectum function before and after the operation were observed.Results The operation time,recovery time of postoperative gastrointestinal function,mean in-hospital time（238.0±54.0）min,（58.5±20.3）h,（7.8±3.5）d,（（90.45±30.5）h in the systematic nerve sparing radical hysterectomy group,and（115.0±39.3）min,（81.3±26.2）h,（17.4±4.5）d,（120.45±23.6）h in radical hysterectomy group respectively.There was a significant difference between the two groups（P0.05）.But there was no significance on blood loss.Conclusion During radical hysterectomy,sparing the PAN may be good,and bladder funcion as well as the anus（or rectal） function recover rapidly.