探讨早期宫颈癌保留生育功能手术的治疗效果及其对患者生活质量的影响

Effect of fertility preserving surgery on early cervical cancer and its effect on quality of life of patients

目的探讨早期宫颈癌保留生育手术对患者治疗效果和生活质量的影响。方法 50例早期宫颈癌患者,随机分为观察组和对照组,各25例。两组术前均进行新辅助化疗,对照组患者行腹腔镜下广泛子宫切除手术,观察组患者行保留生育手术。对比两组围手术期相关指标及标本切除相关指标、复发情况和并发症发生情况、生活质量评分等指标。结果两组手术时间、住院时间、出血量、自主排尿时间及肛门排气时间比较,差异无统计学意义(P>0.05)。观察组阴道切除长度(2.3±0.4)cm以及宫旁组织切除宽度(2.0±0.3)cm均显著短于对照组的(3.2±0.5)、(2.7±0.6)cm,差异有统计学意义(P<0.05);两组宫颈切除长度和盆腔淋巴结切除个数比较,差异无统计学意义(P>0.05)。观察组功能领域评分显著优于对照组,差异有统计学意义(P<0.05);两组主要症状领域评分和其他症状领域评分比较差异无统计学意义(P>0.05)。两组术后均无复发病例。两组并发症发生率比较差异无统计学意义(P>0.05)。结论针对早期宫颈癌患者行保留生育手术效果确切,利于帮助患者改善生活质量且术后并发症较少,值得临床推广。

Objective To investigate the influence of fertility preserving surgery on treatment effect and quality of life in patients with early cervical cancer. Methods A total of 50 patients with early cervical cancer were randomly divided into observation group and control group, with 25 cases in each group. Both groups received neoadjuvant chemotheropy on peroperative. The control group received laparoscopic extensive hysterectomy, and the observation group received fertility preserving surgery. Comparison were made on perioperative related indicators and specimen removal related indicators, occurrence of recurrence and complications, quality of life scores between the two groups. Results Both groups had no statistically significant difference in operative time, hospitalization time, bleeding volume, self-voiding time and anal exhaust time（P〉0.05）. The observation group had obviously shorter length of vaginal excision as（2.3±0.4） cm and paracervical tissue removal width as（2.0±0.3） cm than（3.2±0.5） and（2.7±0.6） cm in the control group, and their difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in length of cervical excision and number of pelvic lymph node dissections（P〉0.05）. The observation group had obviously better functional field score than the control group, and the difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in main symptom field score and other symptom field scores（P〉0.05）. No recurrence was found in all two groups after operation. There was no significant difference in the incidence of complications between the two groups（P〉0.05）. Conclusion The effect of fertility preserving in patients with early cervical cancer is definite, and it helps to improve the quality of life of patients with fewer postoperative complications. It is worthy of clinical promotion.