腹腔镜下保留盆腔自主神经在早期宫颈癌根治术中的应用价值

Laparoscopic nerve sparing radical hysterectomy in early cervical cancer treatment

目的探讨腹腔镜下保留盆腔自主神经的根治性手术(LNSRH)在早期宫颈癌治疗中的临床应用价值。方法按入院先后顺序,将90例需行根治术的早期宫颈癌患者随机分为观察组和对照组,每组45例。对照组行腹腔镜下根治性子宫切除术(LRH),而观察组行LNSRH治疗。比较分析两组患者的术中情况:总手术时间、术中出血量、淋巴结清扫的数量、阴道切除长度、宫旁组织切除长度;术后情况如:膀胱及直肠功能恢复情况等临床指标。结果观察组的总手术时间[(283.2±47.5)min]高于对照组[(201.6±48.7)min],组间差异具有统计学意义(P<0.05);两组间的术中出血量、切除淋巴结数量、宫旁组织切除长度、阴道切除长度的比较,差异无统计学意义(P>0.05);观察组的肛门排气时间、排便时间、拔出尿管时间及术后残余尿量小于100ml时间[分别为:(60.7±10.4)h、(94.6±10.2)h、(10.6±3.9)d、(10.3±4.5)d]均明显少于对照组[(74.5±12.1)h、(122.5±21.0)h、(17.8±4.0)d、(16.7±4.4)d)],组间比较差异具有统计学意义(P<0.05)。结论 LNSRH治疗早期宫颈癌安全、可行,较LRH更有利于术后膀胱、直肠功能的恢复,值得临床推广应用。

Objective To study the clinical application value of the laparoscopic nerve sparing radical hysterectomy （LNSRH） in early cervical cancer treatment. Methods According to the order in hospital, 90 patients with early cervical cancer requires radical were randomly divided into observation group and control group（n=45）. Control group was trea- ted with laparoscopic radical hysterectomy （LRH） treatment, while the observation group with NSRH. The intraopera- tive situation （including.. total operation time, intraoperative blood loss, length of the number of lymph node cleaning, vaginal removal, near the palace resection length） and postoperative （including： the bladder and rectum function recovery and other clinical indicators） were observed. Results The total operation time of observing group （283.2±47.5min） was higher than that of the control group （201.6±48.7min） （P〈0.05）. Intraoperative blood loss, removed lymph node and removed vaginal were not statistically significantly different between the two groups （P〉0. 05）. The anal exhaust time, defecation time, the urine tube used time, and postoperative residual urine volume of the observing group were not different from the control group （P〈0.05）. Conclusion LNSRH is safe, feasible in early cervical cancer treatment, and is more conducive to the postoperative bladder and rectum function recovery.