前列腺癌根治术中性神经保留对术后性功能影响的临床研究

Clinical study on the effect of sexual nerve reservation on postoperative sexual function in radical prostatectomy

目的:探讨前列腺癌根治术中性神经保留对术后性功能影响的临床研究。方法:选自韶关市粤北人民医院与安徽省立医院泌尿外科、合肥市第二人民医院泌尿外科于2014年8月至2016年8月期间收治的前列腺癌患者30例,均行前列腺癌根治术中性神经保留。观察平均手术时间、平均出血量,随访1年单侧和双侧神经性功能恢复情况,术后2周拔尿管后评价残余尿、平均尿流率及尿失禁情况。结果:前列腺癌患者平均手术时间(175. 49±15. 46) min,平均出血量(378. 94±29. 87) m L;保留双侧神经性功能恢复明显优于保留单侧神经,且差异具有统计学意义(P <0. 05);术后2周拔尿管后平均残余尿(4. 87±1. 24) m L,平均尿流率(17. 23±1. 56) m L/s,且未见尿失禁发生。结论:前列腺癌根治术中性神经保留对术后性功能恢复有较好的效果,尤其保留双侧神经恢复效果明显,具有重要研究价值,值得进一步推广应用。

Objective ：To investigate the effect of sexual nerve reservation on postoperative sexual function in radical prostateetomy. Methods：30 patients with prostate cancer treated in our hospitals from August 2014 to August 2016 were treated with radical nerve sparing surgery. The average operation time and average blood loss were observed, and the sexual function recovery- of patients with unilateral and bilateral sexual nerve reservation was followed up for a year. The residual urine, average urine flow rate and urinary incontinence were evaluated atpostoperative 2 weeks with the catheter removal. Results：The average operation time of patients with prostate cancer was （ 175.49± 15.46） min and the average amount of blood losswas （378.94 ± 29.87） mL. The sexual function recov- ery-of patients with bilateral sexual nerve reservation was significantly better than that of patients with unilateral sexual nerve reservation, with statistically significant difference （P 〈 0. 05 ）. At postoperative 2 weeks with the catheter removal, the average residual urine and average urine flow ratewas （4.87 ± 1.24） mL and （ 17.23± 1.56） mL/s respectively, with no urinary- incontinence. Conclusions： Sexual nerve reservation in radical prostateetomy has a good effect on postoperative sexual function recovery, especially with bilateral nerve reservation, which has important research value and is worthy of further popularization and application.