保留盆腔自主神经对宫颈癌患者术后性生活质量影响的探讨

Effect of laparoscopic nerve-sparing radical hysterectomy on the quality of sexual life in patients with early stage cervical cancer

目的探讨腹腔镜下保留盆腔自主神经的广泛子宫切除术（laparoscopic nerve sparing radical hysterectomy,LNSRH）对早期宫颈癌患者术后性生活质量的影响。方法选取2011年8月至2013年3月因早期子宫颈癌（Ⅰa2~Ⅰb1期）于青岛市市立医院行腹腔镜下广泛子宫切除术的患者,采用随机数字表法将其分为2组,其中LNSRH组29例,行LNSRH＋腹腔镜下盆腔淋巴结清扫术（laparoscopic pelvic lymphadenectomy,LPL）,对照组30例,行腹腔镜下广泛子宫切除（laparoscopic radical hysterectomy,LRH）＋LPL（LRH组）。术前及术后1年采用女性性功能指标量表（female sexual function index,FSFI）对所有患者进行问卷调查,评价其性生活质量。结果术前两组FSFI总评分及各部分得分差异无统计学意义,术后LNSRH组FSFI总评分高于LRH组,差异有统计学意义（P〈0.05）。术后各部分评分中性欲望、性唤起、阴道润滑、性高潮、性满意度得分LNSRH组均高于LRH组,差异有统计学意义（P〈0.05）;性交痛评分两组之间差异无统计学意义。结论 LNSRH患者较LRH患者术后有较为理想的性生活状态,LNSRH可能对提高早期宫颈癌患者术后性生活质量有效。

Objective To explore the effect of laparoscopic nerve-sparing radical hysterectomy on the quality of sexual life in patients with early stage cervical cancer. Method Totally 59 cases with cervical cancer of stage Ⅰa2-Ⅰb1 in our hospital from August 2011 to March 2013 were divided in to two groups randomly：29 cases received laparoscopic nerve-sparing radical hysterectomy and pelvic lymphadenectomy（LNSRH group）,and 30 cases received non-nerve-sparing laparoscopic radical hysterectomy and pelvic lymphadenectomy（LRH group）.All the patients were required to fill in FSFI questionair before the operation and one year after the operation.All the patients in the two groups completed their questionairs. Result There was no difference in total score and the score of sexual desire,sexual arouse,vaginal lubrication,orgasm and algopareunia between two groups before operation. The total score of LNSRH group was higher than that of LRH group significantly after operation,and the score of sexual desire,sexual arouse,vaginal lubrication and orgasm was higher in LNSRH group than in LRH group,but there was no significance in the score of algopareunia. Conclusion The condition of sexual life is better in LNSRH group than in LRH group,so it is possible that LNSRH can improve the postoperative quality of sexual life in the patients suffering early stage cervical caner.