保留盆腔自主神经与传统广泛性子宫切除术对宫颈癌术后恢复及并发症的影响

Effects of pelvic autonomic nerve-preserving surgery and traditional radical hysterectomy on postoperative recovery and complications of cervical cancer patients

目的分析保留盆腔自主神经与传统广泛性子宫切除术对宫颈癌术后恢复和并发症的影响。方法选取该院2014年1月-2015年3月收治宫颈癌患者85例为研究对象,依照治疗方法不同分为研究组和对照组,对照组患者采取传统广泛子宫切除术治疗,研究组患者采取保留盆腔自主神经治疗,分析两组患者术后恢复和并发症情况。结果两组患者均顺利完成手术,研究组患者术后保留尿管时间[(11.25±2.09)d]和膀胱残余尿量[(139.51±62.33)ml]显著少于对照组[(15.25±3.27)d、(202.81±83.02)ml],差异有统计学意义(t=6.811、4.002,P<0.05),研究组患者术后肛门排气时间(59.62±13.41)h和排便时间(91.11±11.65)h显著短于对照组肛门排气时间(72.94±16.28)h和排便时间(121.26±23.54)h,差异有统计学意义(t=4.134、7.611,P<0.05)。研究组患者术后5例出现淋巴结转移,对照组4例淋巴结转移,宫旁和引导切缘均为阴性。术后并发症包括尿路感染、淋巴囊肿、尿失禁、便秘等,研究组患者术后便秘(8.89%)、性功能障碍(44.44%)显著低于对照组便秘(25.00%)、性功能障碍(85.00%),差异有统计学意义(χ~2=3.995、15.033,P<0.05),其他差异无统计学意义(χ~2=2.156、1.886、2.304,P>0.05)。结论宫颈癌患者治疗中,采用保留盆腔自主神经手术治疗能够减少术后并发症的发生,有利于膀胱功能的恢复。

Objective To analyze the effects of pelvic autonomic nerve-preserving surgery and traditional radical hysterectomy on postoperative recovery and complications of cervical cancer patients. Methods Eighty-five patients with cervical cancer were selected from the hospital from January 2014 to March 2015 as research object,then they were divided into study group and control group according to treatment methods. The patients in control group were treated by traditional radical hysterectomy,while the patients in study group were treated by pelvic autonomic nerve-preserving surgery. The postoperative recovery and complications of patients in the two groups were analyzed. Results The operation was completed successfully in the two groups. The urinary catheter retention time and residual urine volume after operation in study group were（ 11. 25±2. 09） days and（ 139. 51±62. 33） ml,which were statistically significantly less than those in control group[（ 15. 25±3. 27） days and（ 202. 81±83. 02） ml]（ t=6. 811,4. 002,P〈0. 05）. The postoperative anal exhausting time and defecation time after operation in study group were（ 59. 62±13. 41） hours and（ 91. 11±11. 65） hours,which were statistically significantly shorter than those in control group [（ 72. 94±16. 28） hours and（ 121. 26±23. 54） hours]（ t = 4. 134,7. 611,P〈0. 05）. After operation,lymph node metastasis occurred in five patients in study group and four patients in control group,paracervical and incisal margin were negative. Postoperative complications included urinary tract infections,lymphatic cyst,urinary incontinence,constipation,and so on. The incidence rates of postoperative constipation and sexual dysfunction in study group were 8. 89% and 44. 44%,respectively,which were statistically significantly lower than those in control group（ 25. 00%,85. 00%）（ χ^2= 3. 995,15. 033,P〈0. 05）,there was no statistically significant difference in the incidence rates of other postoperative complications between the two groups（ χ^2= 2. 156, 1. 886, 2. 304, P〈0. 05）.Conclusion Pelvic autonomic nerve-preserving surgery can reduce the incidence rates of postoperative complications and help restore bladder function in treatment of patients with cervical cancer.