宫颈癌患者腹腔镜广泛子宫切除术中盆腔自主神经功能保留对患者性功能的影响分析

Effect of pelvic autonomic nerve preservation on the sexual function in patients with cervical cancer undergoing laparoscopic hysterectomy

目的:探讨宫颈癌患者腹腔镜广泛子宫切除术中盆腔自主神经功能保留对患者性功能的影响。方法:选取本院2014年6月至2015年6月在院并经病理证实为宫颈癌并行腹腔镜下广发全子宫切除术的患者70例,采用随机数字表法分为观察组和对照组各35例,对照组采用常规腹腔镜下广泛子宫切除术,观察组采用腹腔镜下广泛子宫切除术并保留盆腔自主神经,比较两组术后性功能、生命质量及尿流动力学。结果:两组患者术前性功能FAFI评分无明显差异,术后6个月两组患者FAFI评分均较术前下降,差异有统计学意义;观察组术后1年FAFI评分与治疗前无明显差异,对照组术后1年FAFI评分较术前下降,观察组术后6个月、术后1年FAFI评分均明显高于对照组,差异有统计学意义(P<0.05);观察组患者躯体功能及情绪功能均高于对照组,差异有统计学意义(P<0.05);而社会功能评分、认知功能、角色功能及症状子量表总评分、总健康状况评分及总生命质量评分在两组之间无明显差异(P>0.05);观察组患者尿意初始时的膀胱容量、最大排尿量、排尿次数、残余尿体积、尿意强烈的膀胱容量等尿流动力学指标均优于对照组,差异有统计学意义(P<0.05)。结论:保留盆腔自主神经的腹腔镜下广泛子宫切除术有利于宫颈癌患者术后性功能的恢复。

Objectives： To investigate the effect of pelvic autonomic nerve preservation on the sexual function in patients with cervical cancer undergoing laparoscopic hysterectomy. Methods： 70 patients diagnosed as cervical cancer concurrent laparoscopic hysterectomy in our hospital from June 2014 to June 2015 were randomly divided into observation group and control group,with 35 cases in each group. The control group received conventional laparoscopic radical hysterectomy and observation group received laparoscopic hysterectomy surgery and pelvic autonomic nerve preservation. Postoperative sexual functions,quality of sex life and urine flow dynamics of the two groups were compared. Results： The preoperative FAFI scores of two groups had no significant difference and at 6 months after surgery,FAFI scores of two groups decreased significantly. At 1 year after surgery,FAFI score of observation group had no significant difference with that before the surgery. At 1 year after surgery,FAFI score of control group significantly decreased. FAFI scores of observation group at 6 months and 1 year after surgery were significantly higher than these of control group respectively（ P〈0. 05）. The physical function and emotional function of observation group were higher than these of control group（ P〈0. 05）. The score of social function,cognitive function,role function,symptom score,general health status and the total quality of life score of two groups had no significant difference（ P〉0. 05）. The initial bladder capacity during micturition desire,maximum urination,urination times,residual urine volume,urinary bladder capacity during strong micturition desire and other urine flow dynamics indexes of observation group were better than theses of control group. Conclusion： Laparoscopic hysterectomy with pelvic autonomic nerve preservation is beneficial to the recovery of postoperative sexual function in patients with cervical cancer.