保留盆腔自主神经根治性宫颈癌术后患者直肠及性功能的影响

Effect of Radical Resection of Cervical Carcinoma with Pelvic Autonomic Nerve Preservation on Bowel and Sexual Function

目的探讨保留盆腔自主神经根治性宫颈癌术后患者直肠及性功能的影响。方法随机选取73例宫颈癌患者作为本次研究试验对象,观察组患者采用保留盆腔自主神经的根治性宫颈癌术,对照组不保留盆腔自主神经,观察两组患者术中出血量、手术时间、淋巴结切除个数、术后直肠功能、膀胱功能及性功能恢复情况,有无并发症发生,记录并分析比较。结果观察组患者手术时间较长,与对照组比较有统计学意义(P<0.05);但术中出血量、子宫切除时间和淋巴结切除个数与对照组比较无明显差异,两组比较无统计学意义(P>0.05)。术后观察组患者膀胱功能恢复较好,拔除导尿管时间短,各项生理指标均明显优于对照组患者,两组比较有统计学意义(P<0.05)。术后观察组患者排气时间、排便时间以及住院时间均短于对照组患者,两组比较有统计学意义(P<0.05)。观察组患者中只有1例性功能表现为2级,多数患者性功能与治疗前相差不大,但对照组患者有8例术后性功能达2级,两组比较有统计学意义(u=2.5686,P=0.0102)。观察组患者术后只有1例发生尿路感染,总并发症发生率为2.70%,对照组患者并发症稍多,总发生率为13.89%,但两组比较无统计学意义(P>0.05)。结论保留盆腔自主神经的根治性宫颈癌术临床疗效较高,对患者损伤小,并发症少,安全性高,术后直肠功能、膀胱功能以及性功能影响小,恢复快,显著提升生活质量,值得广泛推荐使用于临床当中。

Objective To study the effect of radical resection of cervical carcinoma with pelvic autonomic nerve preser- vation on bowel and sexual function. Methods 73 cases of cervical cancer patients were selected, the observation group were treated with pelvic autonomic nerve preservation of radical cancer surgery, the control group did not retain the pelvic autonomic nerve, blood loss, operation time, the number of lymph nodes removed, postoperative bowel function, bladder function and sexual function recovery,complications of the 2 groups were observed and analyzed. Results Operation time of the observation group was longer than the control group was statistically significance（P 〈 0.05 ） ;but there was no significant difference in blood loss, hysterectomy time and lymph node dissection number between the 2 groups （P 〉 0.05）. Group bladder function of the observation group had good recovery, removal of the catheter was quick, all indexes of the observation group were significantly better than the control group, there had statistical difference（P 〈 0.05）. Postoperative exhaust time, defecation time and hospital stay of the ob- servation group were shorter than the control group, there had statistical difference （ P 〈 0.05 ）. Sexual function of 1 case was grade 2 in the observation group, the majority of patients had similar sexual function with before treatment,, sexual function of 8 cases in the control group was grade 2, the 2 groups had statistical difference（ u = 2.5686 ,P = 0. 0102）. The observation group had 1 case of urinary tract infection,the total complication rate was 2.70% ,which was less than the control group,13.89% ,but there was no significant difference（P 〉 0.05）. Conclusion Radical resection of cervical carcinoma with pelvic autonomic nerve preservation is effective and safe with minimal trauma and fewer complications, postoperative bowel function, bladder function and sexual func- tion have quick recovery and little influence, it can significantly improve the quality of life, and it is worthy of clinical application.