应用腹腔镜手术治疗早期子宫内膜癌患者的临床效果分析

Analysis of pelvic function and sexual function after laparoscopic radical resection of patients with early stage cervical cancer

目的:探讨应用腹腔镜手术治疗46例早期子宫内膜癌患者的临床效果、术后对患者性功能和并发症的影响。方法:选取2015年8月至2016年6月海南医学院第二附属医院接诊的早期子宫内膜癌患者92例,采用随机数表法将其分为观察组和对照组,每组46例患者。观察组患者给予腹腔镜手术治疗,对照组患者给予开腹手术治疗。观察患者术中出血量、术后盆腹腔引流量、术后肛门排气时间、术后下床活动时间、术后住院时间等相关手术指标变化,比较患者手术时间、盆腔淋巴结切除数、腹主动脉旁淋巴结切除数,记录患者术后并发症发生率、性功能恢复情况。结果:观察组患者术中出血量、术后盆腹腔引流量(126. 89±23. 12ml、258. 12±34. 12ml)低于对照组患者(159. 78±25. 45ml、297. 12±34. 89ml),两者差异均具有统计学意义(均P <0. 05);观察组患者的术后肛门排气时间、术后下床活动时间和术后住院时间(32. 12±5. 12h、48. 37±6. 21h、5. 23±0. 54d)短于对照组患者(39. 40±5. 28h、59. 78±5. 88h、9. 23±0. 34d),其差异均具有统计学意义(均P <0. 05);两组患者的手术时间、盆腔淋巴结切除数和腹主动脉旁淋巴结切除数比较,其差异均无统计学意义(均P> 0. 05)。术后患者均出现淋巴囊肿、切口愈合不良、尿潴留、下肢静脉血栓等并发症,观察组患者总发生率(10. 9%)低于对照组患者(32. 6%),其差异均具有统计学意义(均P <0. 05);观察组患者术后性欲、性唤起、性高潮和性心理评分均高于对照组患者,其差异均具有统计学意义(均P <0. 05);观察组患者术后性行为异常评分(56. 12±5. 07分)低于对照组(65. 12±6. 02分),其差异具有统计学意义(P <0. 05)。结论:采用腹腔镜手术治疗早期子宫内膜癌患者,对患者产生的创伤小,患者术后恢复快,术后对患者性功能影响小,能够达到开腹手术切除淋巴结的清扫效果,提高患者的生存质量。

Objective:To investigate the effect of laparoscopic radical resection on the pelvic function and sexual function of patients with early stage cervical cancer.Methods:92 patients with cervical cancer treated in our hospital from December 2015 to November 2016 were selected.By using a random number table method all the patients were divided into two groups,with 46 cases in each group.The control group was given traditional open surgery,and the observation group was treated with laparoscopic surgery.The changes in related surgical indexes,complication rate,sexual function,improvement in and satisfaction of pelvic function between the two groups after treatment were observed and compared.Results:The operation time,lymph nodes between the two groups were compared,without statistically significant differences(P>0.05).The intraoperative blood loss and postoperative pelvic drainage(312.02±21.56ml,126.78±12.56ml)of observation group was lower than these of control group(332.78±22.58ml,220.15±32.02ml),with statistically significant differences(P<0.05).The time of ambulation after operation(42.13±6.02h)in observation group was earlier than that in control group(56.12±6.68h),with statistically significant difference(P<005).The postoperative hospital stay,postoperative anal exhaust time(9.56±2.60d,28.12±3.29h)of observation group were shorter than these of control group(12.12±3.78d,36.12±5.02h),with statistically significant differences(P<0.05).After treatment,the total complication rate of observation group(13.04%)was lower than that of control group(36.96%),with statistically significant difference(P<0.05).After treatment,sexual desire,sexual psychology,sexual arousal,ejaculation time and abnormal sexual behavior symptom scores of observation group were significantly better than these of control group,with statistically significant differences(P<0.05).The satisfaction rate of observation group(91.30%)after treatment was higher than that of control group(76.09%),with statistically significant difference(P<0.05).VRP and VSP of two groups were increased after treatment,and those of observation group were higher than those of control group with statistically significant differences(P<0.05).Conclusion:Laparoscopic surgery in the treatment of early endometrial cancer is of small trauma,fast postoperative recovery and low complications,which can improve the sexual function and pelvic function with significant effect.